MedicaidAdministrativeMedium impact
Participant Resource Amounts During Split Months
Maryland Medicaid·MD · Palliative Care·Provider Transmittal
Effective date
Apr 30, 2021
We identified it
Jun 20, 2026
Summary
This Maryland Medicaid policy clarifies how to calculate and deduct participant resource amounts (nursing facility costs) from hospice reimbursement when enrollment begins mid-month. Hospice providers must enter "0" for mid-month enrollments on the E-Request form and submit a separate Adjustment Form (MDH 4571) after the nursing facility receives split-month payment to correct the resource deduction.
Action Required
By May 31, 2021: Hospice billing staff must update E-Request submission procedures to distinguish between first-day-of-month enrollments (enter full resource amount) and mid-month enrollments (enter "0" with affected dates, and submit Adjustment Form MDH 4571 after nursing facility payment). Train providers completing E-Requests on the split-month calculation process. Update internal documentation and checklists to ensure Notice of Eligibility with resource amounts is attached to all E-Requests. Failure to follow the correct procedure may result in incorrect payment deductions and overpayment recovery demands.