Hospice Election Addendum: Now Mandatory! Tools and Grace!
This week, the Election Addendum became mandatory for all new hospice elections beginning October 1st, 2026. Thankfully, due to significant advocacy, CMS also announced this week that they will provide "enforcement discretion" for quarter one and have ensured the MACs will not deny solely on this new requirement.
Hospices should use this time of grace to ensure they have full compliance with this new condition of payment. We have created an audit tool for your process and form, along with the slides from CMS' presentation last week on the updates. Please let us know if we can help!
The announcement read:
Hospice News & Announcements
Initial Implementation of Mandatory Hospice Election Statement Addendum
Starting October 1, 2026, hospices must give every patient (or their representative) a hospice election statement addendum, in writing, for each hospice election. This addendum tells patients about items, services, and drugs the hospice will not cover because they're unrelated to the patient's terminal illness, and it explains their right to appeal that decision through the Beneficiary and Family-Centered Care Quality Improvement Organization (BFCC-QIO). This new requirement was finalized in a CMS final rule that appeared in the Federal Register in August 2026 (91 FR 49118); before the effective date of this final rule, hospices only had to provide the addendum when a patient asked for it.
To help hospices adjust to the new requirement, from October 1, 2026 to December 31, 2026, while hospices are required to furnish the addendum to every electing beneficiary, CMS will exercise enforcement discretion during this three-month window. During this time, Medicare Administrative Contractors (MACs) will not deny claims solely because the addendum is missing or incomplete and will focus on educating hospices to help them come into full compliance.
See the CMS announcement here: https://www.cms.gov/hospice-news-announcements
Click below to download the Election Addendum Audit Tool and the CMS presentation!
