Hospice election addendum is mandatory for every new election starting October 1
Oct 11, 2026 edition · GC-2026-0140 · Published 2026-10-11 · Version 3 · Effective
CMS requires an election addendum for every hospice election beginning October 1, while allowing a temporary claims-enforcement transition. Delivery, updates, and the signed-record payment condition remain distinct obligations during that period.
What happened
The October 1 newsletter says the FY 2027 hospice payment rule makes the election statement addendum mandatory for all elections on or after October 1. Hospices must furnish it in writing, on paper or electronically, to the beneficiary or representative within five calendar days of the election's effective date. It must contain the information required by 42 CFR 418.24(c). An update is due within three calendar days of a plan-of-care change, so the initial delivery workflow does not complete every later addendum obligation.
CMS describes the payment condition as satisfied when a valid signed addendum is in the beneficiary's hospice medical record. From October 1 through December 31, MACs will not deny claims solely because the addendum is missing or incomplete and will focus on education. The newsletter expressly says furnishing remains required for every electing beneficiary during that window. This temporary enforcement discretion therefore changes the stated claims response to specified documentation defects, while leaving the October 1 furnishing requirement and the need to correct omissions in place.
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
- Audit October elections, five-day delivery, signatures and three-day updates; correct omissions. Internal target. Clinical Operations · Due 2026-10-12
- 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 2026-10-11
Complete edition and supplemental material
This finding in the complete approved report →Regulatory horizons, CIA trends and implementation trackers remain in the full report.
Read the entire Medicare & Medicaid report →