                                 CODE OF VIRGINIA

COVERAGE FOR HOSPICE CARE (§ 38.2-3418.11)

A. Notwithstanding the provisions of &#xA7; 38.2-3419, each insurer proposing to
issue individual or group accident and sickness insurance policies providing
hospital, medical and surgical, or major medical coverage on an expense-incurred
basis; each corporation providing individual or group accident and sickness
subscription contracts; and each health maintenance organization providing a
health care plan for health care services shall provide coverage for hospice
services under such policy, contract or plan delivered, issued for delivery or
renewed in this Commonwealth on and after July 1, 1999.

B. As used in this section:
			&#8220;Hospice services&#8221; shall mean a coordinated program of home and
inpatient care provided directly or under the direction of a hospice licensed
under Article 7 (&#xA7; 32.1-162.1 et seq.) of Chapter 5 of Title 32.1, and
shall include palliative and supportive physical, psychological, psychosocial
and other health services to individuals with a terminal illness utilizing a
medically directed interdisciplinary team.
			&#8220;Individuals with a terminal illness&#8221; shall mean individuals
whose condition has been diagnosed as terminal by a licensed physician, whose
medical prognosis is death within six months, and who elect to receive
palliative rather than curative care.
			&#8220;Medicare&#8221; shall mean Title XVIII of the Social Security Act.
			&#8220;Palliative care&#8221; shall mean treatment directed at controlling
pain, relieving other symptoms, and focusing on the special needs of the patient
as he experiences the stress of the dying process, rather than treatment aimed
at investigation and intervention for the purpose of cure or prolongation of
life.

C. For the purposes of this section, documentation requirements shall be no
greater than those required for the same services under Medicare.

D. Nothing in this section shall prohibit an insurer, corporation, or health
maintenance organization from offering or providing coverage for hospice
services when it cannot be demonstrated that the illness is terminal or for
individuals with life expectancies of longer than six months.

E. The provisions of this section shall not apply to short-term travel, accident
only, short-term nonrenewable policies of not more than six months&#8217;
duration, or to policies or contracts designed for issuance to persons eligible
for coverage under Title XVIII of the Social Security Act, known as Medicare, or
any other similar coverage under state or federal governmental plans.

HISTORY: 1999, c. 858.