RCW 70.126.020(3)(e) Services performed by family members; RCW 70.126.020(3)(f) Services not included in the approved plan of treatment; or Supportive environmental materials (handrails, telephones, air conditioners, and RCW similar devices) 48.21.220(2)(b) Is the coverage structured to create incentives for the use of home health care and hospice care as an alternative to hospitalization? The coverage may have the following characteristics: RCW 48.21.220(2)(a) include reasonable deductibles, coinsurance provisions, and internal maximums; RCW 48.21.220(2)(c) contain provisions for utilization review and quality assurance; RCW 48.21.220(2)(d) require that home health agencies and hospices have written treatment approved by a physician licensed under chapter or RCW, and may require such treatment plans to be reviewed at designated intervals; RCW 48.21.220(2)(h) The coverage may be structured so that services or supplies included in the primary contract are not duplicated in the optional home health and hospice coverage. RCW 48.21.220(5) The issuer, as a condition of reimbursement, may require compliance with home health and hospice certification regulations established by the United States Department of Health and Human Services. Hospice RCW 70.126.030(1) Must Hospice care be provided by a hospice? Care RCW 70.126.030(2) Must a written hospice care plan be approved by a physician and reviewed at designated intervals? RCW 70.126.030(3)(a) Does hospice care include the following when ordered by a physician and included in the approved RCW 70.126.030(3)(b) treatment plan: RCW 70.126.030(3)(c) Short term inpatient care; Care of the terminally ill in an individual’s home on an outpatient basis; RCW 48.21.220(2)(f) Respite care that is continuous care in the most appropriate setting for a maximum of five days per 3 months of hospice care?
RCW 70.126.020(3)(e) RCW 70.126.020(3)(f) RCW 48.21.220(2)(b) RCW 48.21.220(2)(a) RCW 48.21.220(2)(c) RCW 48.21.220(2)(d) RCW 48.21.220(2)(h) RCW 48.21.220(5) Services performed by family members; Services not included in the approved plan of treatment; or Supportive environmental materials (handrails, telephones, air conditioners, and similar devices) Is the coverage structured to create incentives for the use of home health care and hospice care as an alternative to hospitalization? The coverage may have the following characteristics: include reasonable deductibles, coinsurance provisions, and internal maximums; contain provisions for utilization review and quality assurance; require that home health agencies and hospices have written treatment approved by a physician licensed under chapter or RCW, and may require such treatment plans to be reviewed at designated intervals; The coverage may be structured so that services or supplies included in the primary contract are not duplicated in the optional home health and hospice coverage. The issuer, as a condition of reimbursement, may require compliance with home health and hospice certification regulations established by the United States Department of Health and Human Services. Hospice Care RCW 70.126.030(1) RCW 70.126.030(2) RCW 70.126.030(3)(a) RCW 70.126.030(3)(b) RCW 70.126.030(3)(c) RCW 48.21.220(2)(f) Must Hospice care be provided by a hospice? Must a written hospice care plan be approved by a physician and reviewed at designated intervals? Does hospice care include the following when ordered by a physician and included in the approved treatment plan: Short term inpatient care; Care of the terminally ill in an individual’s home on an outpatient basis; Respite care that is continuous care in the most appropriate setting for a maximum of five days per 3 months of hospice care?
checklist-forms-disability-large-group.docx