MedicaidAdministrativeMedium impact
Attention Hospice Providers: Hospice Program Action Form (FA-91) Updated
Nevada Medicaid·NV · Palliative Care·Provider Announcement
Effective date
Apr 27, 2026
We identified it
Jun 21, 2026
Summary
Nevada Medicaid has updated the Hospice Program Action Form (FA-91), specifically clarifying that Section I now requires both a physician's order and discharge summary for hospice discharges. Providers must immediately stop using the old form and switch to the version dated 04/27/2026.
Action Required
Immediately: Download the updated Hospice Program Action Form (FA-91) dated 04/27/2026 from the Nevada Medicaid Provider Portal Forms webpage. Stop using previous versions of the form. Ensure all hospice discharges include both a physician's order and discharge summary as required in Section I of the new form.