(A)#
Except as provided in subparagraphs (B) and (C) and except in such exceptional and unusual circumstances as the Secretary may provide, if an individual makes such an election for a period with respect to a particular hospice program, the individual shall be deemed to have waived all rights to have payment made under this subchapter with respect to—
(i) hospice care provided by another hospice program (other than under arrangements made by the particular hospice program) during the period, and
(ii) services furnished during the period that are determined (in accordance with guidelines of the Secretary) to be— (I) related to the treatment of the individual’s condition with respect to which a diagnosis of terminal illness has been made or (II) equivalent to (or duplicative of) hospice care;
except that clause (ii) shall not apply to physicians’ services furnished by the individual’s attending physician (if not an employee of the hospice program) or to services provided by (or under arrangements made by) the hospice program.
(A)(i)#
hospice care provided by another hospice program (other than under arrangements made by the particular hospice program) during the period, and
(A)(ii)#
services furnished during the period that are determined (in accordance with guidelines of the Secretary) to be—
(I) related to the treatment of the individual’s condition with respect to which a diagnosis of terminal illness has been made or
(II) equivalent to (or duplicative of) hospice care;
(B)#
After an individual makes such an election with respect to a 90-day period or a subsequent 60-day period, the individual may revoke the election during the period, in which case—
(i) the revocation shall act as a waiver of the right to have payment made under this part for any hospice care benefits for the remaining time in such period and (for purposes of subsection (a)(4) and subparagraph (A)) the individual shall be deemed to have been provided such benefits during such entire period, and
(ii) the individual may at any time after the revocation execute a new election for a subsequent period, if the individual otherwise is entitled to hospice care benefits with respect to such a period.
(B)(i)#
the revocation shall act as a waiver of the right to have payment made under this part for any hospice care benefits for the remaining time in such period and (for purposes of subsection (a)(4) and subparagraph (A)) the individual shall be deemed to have been provided such benefits during such entire period, and
(B)(ii)#
the individual may at any time after the revocation execute a new election for a subsequent period, if the individual otherwise is entitled to hospice care benefits with respect to such a period.
(C)#
An individual may, once in each such period, change the hospice program with respect to which the election is made and such change shall not be considered a revocation of an election under subparagraph (B).
(D)#
For purposes of this subchapter, an individual’s election with respect to a hospice program shall no longer be considered to be in effect with respect to that hospice program after the date the individual’s revocation or change of election with respect to that election takes effect.