Curative Care for Hospice Patients under Age 21: Monthly Activity Log
Tuesday, October 1, 2019
As previously communicated, on Sept. 6, 2019, TRICARE implemented a revised hospice benefit to include concurrent hospice services and curative care for the same condition for beneficiaries under age 21. This aligns TRICARE with Medicaid’s model, and can help improve the quality of life for younger patients who suffer from life-threatening conditions. Hospice providers must submit an activity log to Health Net Federal Services, LLC (HNFS) each month concurrent curative services are rendered. To assist, HNFS offers a Concurrent Hospice Services and Curative Care Monthly Service and Activity Log.
In order to qualify for concurrent hospice and curative care, beneficiaries must:
- Be under age 21 with a life expectancy of six months or less, if the terminal illness has run its normal course.
- Meet hospice eligibility and admission criteria.
- Have a referral to a participating hospice from an authorized provider.
- Have a signed and dated certification/attestation of terminal illness from the referring provider and the hospice medical director.
All hospice care requires approval from HNFS. Approval requirements for curative care for beneficiaries under the age of 21 who have elected hospice vary by TRICARE plan type. (The curative care must be for the terminal condition for which hospice was authorized.) Separate TRICARE copayments, cost-shares and deductibles apply for curative care.
- Referring providers must submit a consolidated (palliative and curative) treatment plan to the hospice within three days of the referral.
- Hospice providers must submit a consolidated (palliative and curative) treatment plan, to include a service and activity log form to HNFS Case Management each month the beneficiary is receiving concurrent curative care services. Please use HNFS’ Concurrent Hospice Services and Curative Care Monthly Service and Activity Log. HNFS’ Case Management team will work with the hospice care coordinator on this process.
If curative care is successful, the beneficiary can ask to have the hospice benefit end. If the disease later returns or the beneficiary is diagnosed with a new terminal condition, the beneficiary can get two more 90-day episodes of care, followed by an unlimited number of 60-day periods.
For additional benefit details, please visit our Hospice Care benefit page.