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 been
approved by the office to provide hospice services to hospice
program 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 or
health care provider who owns or operates a hospice program or
facility, or both, that uses an interdisciplinary team directed by a
licensed physician to provide a program of planned and continuous
care for hospice program patients and their families.
(b) The term includes a program that:
(1) provides a continuum of medical or nursing care and other
hospice services to hospice program patients that complies
with:
(A) the:
(i) conditions of participation for inpatient units under 42
U.S.C. 1395 et seq.; and
(ii) accreditation standards as provided in the Medicare
program under 42 U.S.C. 1395x(dd)(2); and
(B) standards adopted under this article; and
(2) provides hospice services to hospice program patients and
complies 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 a
specialized form of interdisciplinary health care that is designed to
alleviate the physical, emotional, social, and spiritual discomforts of
an individual who is experiencing the last phase of a terminal illness
or disease.
(b) The term does not include services provided by a hospital, a
health facility, an ambulatory outpatient surgical center, or a home
health 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" means
a terminally ill patient who:
(1) has been diagnosed by a licensed physician as having a
terminal 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 patient
during the final stages of a hospice program patient's terminal
illness; and
(2) care for the psychological, social, spiritual, and other needs
of the hospice program patient's family before and after the
hospice 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 a
payment rate to a hospice program for hospice services provided to
hospice program patients who are eligible for medical assistance
under 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 following
conditions:
(1) Be determined in accordance with a prospective payment
rate that is reasonable and adequate to meet the costs that must
be incurred by efficiently and economically operated hospice
programs to provide services in conformity with applicable state
and federal laws, rules, and regulations, including the federal
Social Security Act, and quality and safety standards.
(2) Include the increased costs for medical care, including
physician and nursing care, intensive case management, social
services, 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 implement
this chapter. As added by P.L.24-1997, SEC.54.
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 been
approved by the office to provide hospice services to hospice
program 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 or
health care provider who owns or operates a hospice program or
facility, or both, that uses an interdisciplinary team directed by a
licensed physician to provide a program of planned and continuous
care for hospice program patients and their families.
(b) The term includes a program that:
(1) provides a continuum of medical or nursing care and other
hospice services to hospice program patients that complies
with:
(A) the:
(i) conditions of participation for inpatient units under 42
U.S.C. 1395 et seq.; and
(ii) accreditation standards as provided in the Medicare
program under 42 U.S.C. 1395x(dd)(2); and
(B) standards adopted under this article; and
(2) provides hospice services to hospice program patients and
complies 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 a
specialized form of interdisciplinary health care that is designed to
alleviate the physical, emotional, social, and spiritual discomforts of
an individual who is experiencing the last phase of a terminal illness
or disease.
(b) The term does not include services provided by a hospital, a
health facility, an ambulatory outpatient surgical center, or a home
health 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" means
a terminally ill patient who:
(1) has been diagnosed by a licensed physician as having a
terminal 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 patient
during the final stages of a hospice program patient's terminal
illness; and
(2) care for the psychological, social, spiritual, and other needs
of the hospice program patient's family before and after the
hospice 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 a
payment rate to a hospice program for hospice services provided to
hospice program patients who are eligible for medical assistance
under 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 following
conditions:
(1) Be determined in accordance with a prospective payment
rate that is reasonable and adequate to meet the costs that must
be incurred by efficiently and economically operated hospice
programs to provide services in conformity with applicable state
and federal laws, rules, and regulations, including the federal
Social Security Act, and quality and safety standards.
(2) Include the increased costs for medical care, including
physician and nursing care, intensive case management, social
services, 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 implement
this chapter. As added by P.L.24-1997, SEC.54.
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 been
approved by the office to provide hospice services to hospice
program 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 or
health care provider who owns or operates a hospice program or
facility, or both, that uses an interdisciplinary team directed by a
licensed physician to provide a program of planned and continuous
care for hospice program patients and their families.
(b) The term includes a program that:
(1) provides a continuum of medical or nursing care and other
hospice services to hospice program patients that complies
with:
(A) the:
(i) conditions of participation for inpatient units under 42
U.S.C. 1395 et seq.; and
(ii) accreditation standards as provided in the Medicare
program under 42 U.S.C. 1395x(dd)(2); and
(B) standards adopted under this article; and
(2) provides hospice services to hospice program patients and
complies 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 a
specialized form of interdisciplinary health care that is designed to
alleviate the physical, emotional, social, and spiritual discomforts of
an individual who is experiencing the last phase of a terminal illness
or disease.
(b) The term does not include services provided by a hospital, a
health facility, an ambulatory outpatient surgical center, or a home
health 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" means
a terminally ill patient who:
(1) has been diagnosed by a licensed physician as having a
terminal 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 patient
during the final stages of a hospice program patient's terminal
illness; and
(2) care for the psychological, social, spiritual, and other needs
of the hospice program patient's family before and after the
hospice 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 a
payment rate to a hospice program for hospice services provided to
hospice program patients who are eligible for medical assistance
under 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 following
conditions:
(1) Be determined in accordance with a prospective payment
rate that is reasonable and adequate to meet the costs that must
be incurred by efficiently and economically operated hospice
programs to provide services in conformity with applicable state
and federal laws, rules, and regulations, including the federal
Social Security Act, and quality and safety standards.
(2) Include the increased costs for medical care, including
physician and nursing care, intensive case management, social
services, 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 implement
this chapter. As added by P.L.24-1997, SEC.54.
