Starting October 1, CMS requires a written hospice election statement addendum for every election—not only when someone requests it. The addendum must contain the information required by 42 CFR §418.24(c), reach the beneficiary or representative within five calendar days of the election, and be updated within three calendar days of a plan-of-care change. A valid signed copy must be in the medical record for payment. CMS will exercise enforcement discretion through December 31, but the requirement is active now.

DomAfina’s take: use the three-month window as a live drill. Trigger the addendum from the election date, track delivery and signature separately, start a three-day clock when the care plan changes, and block billing if the signed copy is missing. Audit ten October admissions from election to chart to claim. The safe date is not December 31. It is the first day your workflow can prove every handoff.

Source reviewed: CMS MLN Connects: Initial Implementation of the Mandatory Election Statement Addendum. The source supports the reported update; the operational recommendations are DomAfina’s analysis.