Effective October 1, 2026, hospices must furnish the election statement addendum to every Medicare beneficiary or representative electing hospice care. This change makes the notice part of the standard election process rather than a document produced only upon request.
Get the updated CMS model addendum
CMS updated its model Patient Notification of Hospice Non-Covered Items, Services, and Drugs in August 2026. Open the official PDF below to view or save a copy.
Download the CMS Model Addendum (PDF)
This is the official CMS model beneficiary notice. It is a reference for agency forms, not a SouthStart policy manual addendum.
What the addendum explains
The notice identifies conditions, items, services, and drugs that the hospice determines are unrelated to the beneficiary’s terminal illness and related conditions, and therefore are not covered by the hospice under the Medicare hospice benefit. Its explanation should be understandable to the beneficiary or representative.
Two deadlines to build into your process
- Initial notice: Furnish the written addendum, on paper or electronically, within five calendar days of the effective date of the hospice election.
- Updated notice: Furnish an updated addendum within three calendar days of a plan-of-care change that affects the addendum determinations.
The notice must include the content required by 42 CFR §418.24(c). Keep it with the election statement in the medical record and connect the update process to clinical review.
A signature acknowledges receipt
The CMS model explains that signing acknowledges receipt of the notice; it does not mean the beneficiary or representative agrees with the hospice’s determinations. Staff should explain that distinction clearly. The model also distinguishes the date the notice is furnished from the date it is signed.
The transition period does not delay implementation
From October 1 through December 31, 2026, CMS is exercising enforcement discretion: Medicare Administrative Contractors will focus on education and will not deny claims solely because the addendum is missing or incomplete. Hospices are still required to furnish it during this period.
What hospice providers should review now
This change reaches beyond the admission packet. SouthStart recommends reviewing both policy language and the procedures staff follow each day:
- Election and admission procedures, including responsibility for preparing and furnishing the notice.
- Clinical review of related and unrelated conditions, items, services, and drugs.
- Plan-of-care workflows that identify when an updated addendum is needed.
- Medical-record filing, deadline tracking, and beneficiary communication.
- Staff education and compliance audits to check that the process works in practice.
An admission checklist or electronic record reminder can help staff track deadlines. A separate review trigger for later plan-of-care changes helps keep the notice current after admission.
SouthStart regulatory note
A new beneficiary notice can affect admission policies, clinical responsibilities, records, and auditing. Review the form alongside those procedures so the written policy and daily workflow support the same requirement.