1.Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A. "Hospice care services" means services provided on a 24-hours-a-day, 7-days-a-week basis to a person who is terminally ill
and that person's family. "Hospice care services" includes, but is not limited to, physician services; nursing care; respite
care; medical and social work services; counseling services; nutritional counseling; pain and symptom management; medical
supplies and durable medical equipment; occupational, physical or speech therapies; volunteer services; home health care services;
and bereavement services. [RR 2001, c. 1, §36 (RAL).]
B. "Person who is terminally ill" means a person that has a medical prognosis that the person's life expectancy is 12 months
or less if the illness runs its normal course. [RR 2001, c. 1, §36 (RAL).]
[
RR 2001, c. 1, §36 (RAL)
.]
2.Coverage for hospice care services.
All health maintenance organization individual and group health contracts must provide coverage for hospice care services
to a person who is terminally ill. Hospice care services must be provided according to a written care delivery plan developed
by a hospice care provider and the recipient of hospice care services. Coverage for hospice care services must be provided
whether the services are provided in a home setting or an inpatient setting.
[
RR 2001, c. 1, §36 (RAL)
.]
3.Application.
The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered,
issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed
no later than the next yearly anniversary of the contract date.
[
2003, c. 517, Pt. B, §29 (NEW)
.]
SECTION HISTORY
RR 2001, c. 1, §36 (RAL).
2003, c. 517, §B29 (AMD).
Data for this page extracted on 10/16/2012 08:29:52.