26-840 Prior Authorization Now Required for Outpatient Hospice Services

By July 9, 2026: (1) Billing team must update internal workflows to require prior authorization for all outpatient hospice services for Community Health Plan of Imperial Valley Medi-Cal members. (2) Immediately discontinue use of HospiceCTIforms@centene.com email submission; this inbox will be disabled September 14, 2026. (3) Configure billing system to flag all hospice referrals for prior authorization submission through standard channels (fax, phone, or provider portal). (4) Update provider encounter forms and checklists to require collection of all mandatory documentation at point of service: Certificate of Terminal Illness (CTI), Medi-Cal Hospice Program Election Notice, initial plan of care, transfer/discharge summaries, face-to-face encounter documentation for members beyond three benefit periods, and Patient Notification of Hospice Non-Covered Items form. (5) Establish process to submit complete prior authorization requests at initial hospice admission and at each recertification period for existing patients. (6) Train billing and prior authorization staff on new submission requirements and standard channel procedures. Failure to obtain prior authorization will result in claim denials; incomplete requests will delay payment.