• Medicaid will reimburse for the curative care separately from the hospice services. Medicaid will not reimburse for these types of treatments when they are used palliatively.
• Palliative care is always a part of hospice and included in the hospice per diem reimbursement; therefore, cannot be billed separately or reimbursed by Medicaid.
• Palliative care is defined as an active patient and family–centered approach to pain and symptom management of the terminal illness.
• Where as, curative care is defined as medically necessary care that serves to eliminate the symptoms of a disease with the goal of long term disease-free state.
• For further instructions on concurrent hospice and curative care for children under 21 reference the Hospice Chapter, Section 6.8 of the Michigan Medicaid Provider Manual.

The following bulletin issued in 2014 describes that the Michigan Medicaid program covers hospice care for children less than 21 years of age concurrently with curative treatment of the child’s terminal illness when the child qualifies for hospice as described in the Medicaid Provider Manual.

Other documents

In March 2011, the Michigan Department of Community Health issued a bulletin to inform hospice providers, Medicaid Health Plans, MIChild Health Plans, and other affected groups of the policy changes brought on by Section 2302 of the Affordable Care Act, which would remove the prohibition of receiving curative treatment alongside hospice services for Medicaid and Children’s Health Insurance Program (CHIP) recipients under age 21. The bulletin noted that the Michigan Medicaid program, MIChild and CSHCS program will be following suit immediately. The bulletin is listed as bulletin number MSA 11-11 and may be accessed through the Michigan Department of Health and Human Services under the Medicaid 2011 Policy Bulletins at this link.

The purpose of the Bulletin Number: MSA 14-56 Michigan Medicaid program bulletin is to ensure medically necessary, appropriate and cost-effective utilization of both hospice and curative care when provided concurrently to a Medicaid beneficiary less than 21 years of age.