Hospice Election Statement Addendum: What Changes in FY 2027?

The Hospice Election Statement Addendum specifies the conditions, items, services, or drugs that the hospice has determined are not related to the patient's terminal illness and related conditions and therefore are not covered under the Medicare hospice benefit. Previously, the addendum was provided when requested by the beneficiary or their representative.

Beginning with hospice elections on or after October 1, 2026, hospices will be required to provide the addendum to all Medicare beneficiaries who elect hospice, not only those who request it. As a result, the addendum becomes a more routine part of the hospice election and admission process.

At first glance, the change may appear to be just another documentation requirement. However, its purpose extends beyond adding another form to the admission packet. The addendum is designed to give patients and their families a clearer understanding of which conditions, services, items, or drugs the hospice considers related or unrelated to the terminal illness.

Those determinations can affect which services the hospice is responsible for providing and which may be billed outside the hospice benefit. Greater transparency can help reduce confusion among patients, families, hospice staff, and other healthcare providers involved in the patient's care.

This also means hospices need to be confident that their procedures for determining, communicating, and documenting related and unrelated services are consistent.

As the new requirement approaches, hospice organizations should consider how the addendum currently fits into their workflow. Does the admissions team know when it needs to be provided? Is responsibility for explaining the document clear? How are coverage decisions documented and updated when a patient's circumstances change?

These are important questions to consider before the new requirement becomes part of every applicable Medicare hospice election. Although the addendum may be a single document, the processes behind it can affect admissions, clinical operations, billing, compliance, and patient education.

The mandatory Hospice Election Statement Addendum is just one component of the FY 2027 Hospice Final Rule. In The Hospice Final Rule & 2027 Quality Update, Melinda A. Gaboury takes a broader look at the finalized requirements, including hospice payment updates, the Hospice Quality Reporting Program, the Service and Spending Variation Index (SSVI), face-to-face requirements, and other compliance and operational changes hospice organizations need to understand.

For hospice professionals preparing for FY 2027, the webinar offers a more in-depth look at the changes and what they may mean for day-to-day operations.