Effective May 1, 2024, physicians must enroll in Medicare or opt out for Medicare to pay for hospice services. Earlier this year, the Centers for Medicare & Medicaid Services (CMS) sent instructions to Medicare Administrative Contractors on the new requirements:

1. Hospice medical director or the physician member of the hospice interdisciplinary group who certifies the patient’s terminal condition
2. Patient-designated attending physician (if they have one) who certifies their terminal condition

If a referring physician is currently enrolled or opted out, they will not need to do anything.

This new requirement:

• Only applies to Fee-for-Service Medicare
• Doesn’t prohibit the patient’s independent attending physician from treating them while in hospice and billing for these services under Part B
• Applies to all written or oral certifications under § 418.22(c)

Hospices can quickly verify a physician’s enrollment or opt-out status using the CMS ordering and referring data file (ORDF), which lists all Medicare-enrolled and opted-out physicians. CMS will modify the ORDF to create a separate column with this status.