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Hospice Election Requirements for Dual-Eligible Members and MassHealth Hospice Election Form Update

November 9, 2020

On October 29, 2020, MassHealth issued Hospice Provider Bulletin 15, which communicates a reminder to hospice providers delivering services to dual-eligible MassHealth members and to ensure members elect or revoke the hospice benefit simultaneously through Medicare and MassHealth.

The MassHealth Hospice Provider Bulletin can be accessed at

On October 29, 2020, MassHealth issued an updated MassHealth Hospice Election Form, which replaces all previous version of the MassHealth Hospice Election Form. Hospice providers will have 30 days following the effective date of the bulletin (October 29, 2020) to implement the updated MassHealth Hospice Election Form.

Note: any submission using previous versions of the MassHealth Hospice Election Form following the implementation date will not be processed.

The MassHealth Hospice Election Form can be accessed at

If you or your agency has questions, please contact the LTSS Service Center at (844) 368-5184 or