MedicaidAdministrativeMedium impact
Hospice Revocation Requirements
Nevada Medicaid·NV · Palliative Care·Provider Announcement
Effective date
Aug 14, 2026
We identified it
Aug 15, 2026
Summary
Nevada Medicaid has updated hospice revocation procedures, requiring the recipient or representative to sign the Nevada Medicaid Hospice Program Action Form (FA-91) and submit it to the hospice provider for approval. Hospitals with pending prior authorizations due to overlapping hospice assignments can now use this form to expedite revocation; they can also contact Gainwell Technologies at 800-525-2395 to identify the hospice provider if unknown.
Action Required
Immediately (effective August 14, 2026): Billing and clinical teams must update hospice revocation workflows for Nevada Medicaid patients. (1) Obtain the Nevada Medicaid Hospice Program Action Form (FA-91) from the Nevada Medicaid website and ensure it is available to patients and representatives. (2) When a patient or representative requests hospice revocation, provide form FA-91 for their signature. (3) For hospital billers with pending prior authorizations blocked by overlapping hospice assignments, upload the signed FA-91 form directly to the hospital's prior authorization in the system. (4) If the hospice provider cannot be identified, contact Gainwell Technologies PA contact center at 800-525-2395 to obtain provider information before submitting the revocation form. (5) Do not process hospice care billing or prior authorization approvals until the signed FA-91 form is received and processed by the hospice provider. Update intake and patient communication templates to reference this requirement.