Medicare AdvantageAdministrativeHigh impact
Update to Claims Submission and Billing Guidelines for Hospice
Florida Blue·FL · Palliative Care·Claims & Billing
Effective date
May 1, 2026
We identified it
Jun 16, 2026
Summary
Florida Blue Medicare Advantage now requires hospice claims for services unrelated to terminal prognosis to be submitted first to Original Medicare, then to the Medicare Advantage plan with MSN/EOB for secondary consideration. Claims submitted directly to Medicare Advantage or without MSN/EOB will be denied with code MDHOS.
Action Required
By May 1, 2026: Billing team must update workflow for Florida Blue Medicare Advantage hospice members. Submit Part A and Part B claims for services unrelated to terminal prognosis to Original Medicare first, then submit to Medicare Advantage plan with MSN or EOB for secondary processing. Update billing system to prevent direct submission to Medicare Advantage for hospice patients. Claims submitted incorrectly will deny with MDHOS code.