Newsletter Vol. 2, No. 04

REQUIREMENTS: Immediate (Ongoing Compliance): - Billing/administrative team must ensure front desk and intake staff provide written advance directive information to ALL adult Medicaid patients at the following touchpoints: hospital admission, nursing facility admission, before home health/personal care services begin, upon initial hospice enrollment, and upon HMO enrollment. - Medical records team must document in each patient's medical record whether or not an advance directive has been executed. This documentation is required for all adult Medicaid patients. - Providers and billing staff must never condition care provision or discriminate against patients based on advance directive status. - HR/Compliance must ensure ALL staff (clinical and administrative) receive education on advance directive requirements and Patient Self-Determination Act provisions. One-Time Setup: - Legal/Compliance team must develop and maintain written policies and procedures regarding patient rights to make medical decisions and formulate advance directives, consistent with New Jersey State law. - Provider must include written statement of New Jersey law (provided by Department of Health) regarding patient rights in all patient information materials. - For religious affiliated institutions: develop and document institutional policies defining circumstances where advance directive implementation will be declined based on conscientious objection; include in written policy statement. Consequences: Failure to comply with Patient Self-Determination Act requirements may result in loss of Medicaid program participation, regulatory sanctions, and potential denial of claims for services provided without proper advance directive notification and documentation.