Hospice care is a benefit under the hospital insurance program.  To be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare and be certified as being terminally ill.  An individual is considered to be terminally ill if the medical prognosis is that the individual’s life expectancy is 6 months or less if the illness runs its normal course.  Only care provided by (or under arrangements made by) a Medicare certified hospice is covered under the Medicare hospice benefitThe Medicare Administrative Contract (MAC)  provider for Louisiana and  Mississippi is Palmetto GBA. The MAC Guidelines for determining hospice appropriateness are found at the bottom of this page under the Palmetto logo.  

Louisiana and Mississippi Medicaid recipients are also eligible for hospice services similar to the Medicare Hospice Benefit.  Of note to the Louisiana hospice providers, Medicaid only patients' eligibility requirements are guided by the Local Coverage Determination L32015. However, Louisiana recipients participating in "Healthy Louisiana" Health Care plans and Mississippi recipients follow eligibility requirements associated with Palmetto GBA.  

(Additional information on L32015 may be found. Go to page #3032.)


 Palmetto GBA is a private company contracted with CMS to administer, regulate and reimburse Medicare Part A and some Part B services.  They also execute other CMS related functions, i.e. CAP, cost report.  CMS identifies and has assigned Palmetto GBA as Louisiana’s and Mississippi’s hospices fiscal intermediary (FI). As a result, LMHPCO providers members are provided written guidance, such as the Local Coverage Determinations, by Palmetto GBA.  

Palmetto GBA offers information on hospice eligibility requirements via the LCDs (Local Coverage Determinations).  LCDs identified include: Cardiopulmonary; Dementia; HIV Disease; Alzheimer's Disease; Renal Disease; Adult Failure to Thrive; and Neurological Conditions.  There is no specific LCD Criteria listing for Cancer.  Follow the link below for additional information on the LCDs.

Click here to go Palmetto GBA's LCDs (Local Coverage Determinations)