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Updates To The MassHealth Hospice Election Form and The MassHealth Hospice Enrollment Unit

December 2, 2019

MassHealth published an updated Hospice Election Form, effective November 18, 2019. Hospice providers should use the updated Hospice Election Form as of the effective date. The form can be found at

Hospice providers submit election forms for the following situations:

For members electing hospice

For members changing hospice providers

For members revoking their election of hospice

For members disenrolling or being disenrolled

Pursuant to 130 CMR 437.412(C), hospice providers must complete the MassHealth Hospice Election Form according to the instructions on the form and submit the form to the MassHealth Hospice Enrollment Unit. 

The MassHealth Hospice Enrollment Unit has transitioned from UMASS to OLTSS's Third Party Administrator, Optum, effective November 18, 2019. Hospice providers should refer to Hospice Provider Bulletin 14 for clarification on the transition of the MassHealth Hospice Enrollment Unit including updated contact information and details on submitting the Hospice Election Form. 

Hospice Provider Bulletin 14:

If you have any questions, please contact the LTSS Provider Service Center at or call (844) 368-5184.