Hospice Prior Authorization Medical Necessity Changes

Posted August 4th, 2011 by mfoster & filed under Newsroom, Provider News.

Effective August 15, 2011, the required documentation to support medical necessity for hospice admissions will change.  Our current guidelines only require the physician certification signed by the attending physician and the hospice medical director to be submitted for prior authorization.  Effective August 15, 2011, Magnolia Health Plan will require in addition to the physician certification, a patient election form, a history and physical by the attending physician with the terminal diagnosis listed.  All hospice prior authorizations will be evaluated for medical necessity using the medical necessity criteria developed by the Louisiana Mississippi Hospice and Palliative Care Organization.