Hospice Services

For a member who is terminally ill and who decides to forego curative care for his or her terminal illness, hospice provides palliative care that will provide pain management for the terminal illness and related conditions. In addition to pain management, hospice includes other medical, physical, intellectual, emotional, social and spiritual services for the member and his/her family or natural caregivers consistent with the member’s wishes and needs
Hospice Eligibility
A member must be diagnosed with a terminal illness by a hospice or attending physician. The physician certifies, in writing, that the terminal illness will result in a projected life expectancy of six months or less if the disease follows its normal course.
Hospice Interdisciplinary Team
Each hospice member will be part of a hospice Interdisciplinary Team (IDT). Hospice provider staff assigned to the hospice IDT are the physician, registered nurse, social worker; and pastoral or other counselor. The IDT professional staff must provide the care and services offered by the hospice; and the IDT must supervise the care and the services provided to the member. The IDT develops a hospice Plan of Care (POC) that meets the member’s needs. The POC is updated as frequently as the member’s condition requires; but no less than every 15 calendar days.  
Hospice services may be provided in a home in the community or in a nursing facility.
Any of the following services may be provided based on the needs of the hospice member and caregivers.
Nursing Occupational Therapy
Physician Services Speech Therapy
Spiritual Counseling Physical Therapy 
Dietary Counseling Drugs & Biologicals (related to the terminal illness) 
Bereavement Counseling Medical Equipment  
Hospice Aide Short Term Inpatient Care  
Homemaker Inpatient Respite
Volunteer Services
Other Services – Any other service that is medically necessary for the palliation and management of the member’s terminal illness and related conditions that is otherwise reimbursable under the Iowa Medicaid Enterprise (IME)

Hospice Reimbursement
A hospice provider is reimbursed a daily rate for each day that a member is eligible for hospice. There are four categories of daily rates dependent upon the type of care that the member needs on each day:

  1. Routine
  2. Continuous
  3. Inpatient Respite
  4. General Inpatient Care
Hospice Rate Sheets (October 1, 2015 - December 31, 2015)
Daily rates are fixed rates that are updated annually in accordance with the following posted schedule: