Hospice election addendum is mandatory for every new election starting October 1
Oct 4, 2026 edition · GC-2026-0140 · Published 2026-10-04 · Version 2 · Effective
Every new hospice election from October 1 requires a written election-statement addendum, furnished within five calendar days. CMS also requires timely updates and a valid signed record. October–December enforcement discretion concerns claim denials for missing or incomplete addenda; it does not make the document optional.
What happened
CMS’s October 1 MLN Connects explains changes made in the FY 2027 Hospice Prospective Payment System final rule. The election-statement addendum is mandatory for every hospice election starting on or after October 1, rather than only when a beneficiary asks for one. It must be furnished in writing, on paper or electronically, to the beneficiary or representative within five calendar days of the election’s effective date. CMS says it must contain the information required by 42 CFR 418.24(c), making the content of the document as relevant as whether a form was generated.
When the plan of care changes, an updated addendum must be furnished within three calendar days. The newsletter states that the payment condition is satisfied when the hospice medical record contains a valid signed addendum. To support the transition, CMS will use enforcement discretion from October 1 through December 31: contractors will not deny a claim solely because the addendum is absent or incomplete and will emphasize education. The same notice nevertheless requires hospices to furnish it to every electing beneficiary during those months. That distinction preserves the delivery and recordkeeping duties while explaining the limited temporary claims treatment.
Scope and timing
- Authority status
- Effective
- Applicability
- Operationally relevant
- Audience
- Health systems, Provider networks
- Jurisdiction
- Federal
- Affected functions
- Clinical Operations, Compliance, Revenue Cycle
- Responsible owner
- Clinical Operations
- Recorded date
- 2026-10-01
- Date type
- effective
Why it matters
Election documentation affects payment and patient understanding of excluded services. The temporary non-denial policy is a transition allowance, not an optional addendum.
Recommended action
Validate October elections, delivery dates, signatures, excluded-service explanations and the three-day update workflow. Correct omissions promptly.
Implementation playbook
- Validate October elections, delivery dates, signatures, excluded-service explanations and the three-day update workflow. Correct omissions promptly. Clinical Operations · Due 2026-10-09
- Record the applicability assessment and validate the affected workflow with its operational owner. This is an internal review target, not an additional statutory deadline. Compliance · Due 2026-10-12
Sources
- MLN Connects, October 1, 2026Official · CMS · 2026-10-01 · Source review 2026-10-04
Complete edition and supplemental material
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