MedicaidAdministrativeHigh impact
Separate Forms for Notification of Initial Election Period; Continuing Benefit Period and Recertification of Terminal Illness; and Patient Discharge
Illinois Medicaid - HFS·IL · Palliative Care·Provider Notice
Effective date
Jun 10, 2016
We identified it
Jun 20, 2026
Summary
Illinois has replaced the single HFS 1592 hospice notification form with three separate forms: HFS 1592 for initial elections, HFS 1593 for continuing benefit periods and recertification, and HFS 1594 for patient discharge. Hospice providers must begin using the new forms immediately.
Action Required
Immediately: Hospice billing team must stop using the old HFS 1592 form and begin using the three new forms: HFS 1592 for initial hospice elections (with physician certification attached), HFS 1593 for continuing benefit periods and recertification (with physician certification attached), and HFS 1594 for patient discharge (with specific discharge reason). Download the new PDF-fillable forms dated 02-16 from the Department's Medical Forms page and update billing workflows accordingly.