26-838 Prior Authorization Now Required for Outpatient Hospice Services

REQUIREMENTS: - By September 14, 2026: Billing and administrative staff must immediately cease all email submissions to HospiceCTIforms@centene.com. This inbox will be disabled on this date. - Effective July 9, 2026: Billing team must update all hospice service workflows to require prior authorization through standard submission channels (fax, phone, or Health Net provider portal only). - Before July 9, 2026: Update all hospice referral processes and encounter documentation templates to include mandatory collection of: 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 continuing beyond three benefit periods), and Patient Notification of Hospice Non-Covered Items, Services and Drugs form. - Immediately: Train billing staff on new submission requirements and contact procedures (Medi-Cal: 800-675-6110). Instruct providers that incomplete requests will delay review and payment. - For existing hospice patients: At next recertification period, submit prior authorization request with all required documentation through standard channels. - Establish tracking system to ensure all hospice prior authorizations are submitted through compliant channels only. Claims processed without proper prior authorization will be denied.