CHAPTER 40. PAYMENT FOR HOSPICE SERVICES

IC 12-15-40
    Chapter 40. Payment for Hospice Services

IC 12-15-40-1
Applicability of chapter
    Sec. 1. This chapter applies to a hospice program that has beenapproved by the office to provide hospice services to hospiceprogram patients.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-2
"Hospice" defined
    Sec. 2. (a) As used in this chapter, "hospice" means a person orhealth care provider who owns or operates a hospice program orfacility, or both, that uses an interdisciplinary team directed by alicensed physician to provide a program of planned and continuouscare for hospice program patients and their families.
    (b) The term includes a program that:
        (1) provides a continuum of medical or nursing care and otherhospice services to hospice program patients that complieswith:
            (A) the:
                (i) conditions of participation for inpatient units under 42U.S.C. 1395 et seq.; and
                (ii) accreditation standards as provided in the Medicareprogram under 42 U.S.C. 1395x(dd)(2); and
            (B) standards adopted under this article; and
        (2) provides hospice services to hospice program patients andcomplies with standards adopted under this article.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-3
"Hospice program" defined
    Sec. 3. (a) As used in this chapter, "hospice program" means aspecialized form of interdisciplinary health care that is designed toalleviate the physical, emotional, social, and spiritual discomforts ofan individual who is experiencing the last phase of a terminal illnessor disease.
    (b) The term does not include services provided by a hospital, ahealth facility, an ambulatory outpatient surgical center, or a homehealth agency unless the entity has a distinct hospice program.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-4
"Hospice program patient" defined
    Sec. 4. As used in this chapter, "hospice program patient" meansa terminally ill patient who:
        (1) has been diagnosed by a licensed physician as having aterminal illness;
        (2) is expected to die from the terminal illness within six (6)

months; and
        (3) receives hospice services from a hospice program.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-5
"Hospice services" defined
    Sec. 5. As used in this chapter, "hospice services" means:
        (1) palliative care for the physical, psychological, social,spiritual, and other special needs of a hospice program patientduring the final stages of a hospice program patient's terminalillness; and
        (2) care for the psychological, social, spiritual, and other needsof the hospice program patient's family before and after thehospice program patient's death.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-6
Payment rate
    Sec. 6. The office shall, under 42 U.S.C. 1396 et seq., establish apayment rate to a hospice program for hospice services provided tohospice program patients who are eligible for medical assistanceunder this article.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-7
Conditions of payment
    Sec. 7. Payment to a hospice program must meet the followingconditions:
        (1) Be determined in accordance with a prospective paymentrate that is reasonable and adequate to meet the costs that mustbe incurred by efficiently and economically operated hospiceprograms to provide services in conformity with applicable stateand federal laws, rules, and regulations, including the federalSocial Security Act, and quality and safety standards.
        (2) Include the increased costs for medical care, includingphysician and nursing care, intensive case management, socialservices, and pharmaceutical and allied health costs.
As added by P.L.24-1997, SEC.54.

IC 12-15-40-8
Adoption of rules
    Sec. 8. The office shall adopt rules under IC 4-22-2 to implementthis chapter.
As added by P.L.24-1997, SEC.54.