CMS Provides Guidance on Hospice Benefits for Children Pursuant to Healthcare Reform

CMS recently issued guidance on Section 2302 of the Patient Protection and Affordable Care Act–the 2010 healthcare reform law. “Section 2302 of the law amends sections 1905 (o)(1) and 2110(a)(23) of the Social Security Act to remove the prohibition of receiving curative treatment upon the election of the hospice benefit by or on behalf of a Medicaid or Children’s Health Insurance Program (CHIP) eligible child.” CMS continues to explain that “[t]he Affordable Care Act does not change the criteria for receiving hospice services; however, prior to enactment of the new law, curative treatment of the terminal illness ceased upon election of the hospice benefit. This new provision requires States to make hospice services available to children eligible for Medicaid and children eligible for Medicaid-expansion CHIP programs without forgoing any other service to which the child is entitled under Medicaid for treatment of the terminal condition.”

For those states with independent CHIP programs, they still are not required to provide hospice services; however, if hospice services are provided, the concurrent curative treatment must be offered. CMS contends that this will increase utilization of hospice services.

For more information, please contact Abby Pendleton, Esq. and Jessica L. Gustafson, Esq. at (248) 996-8510 or (212) 734-0128, visit our Hospice Providers specialty page, or the HLP website.