SHPBN-2016-032 Hospice Pharmacy Benefit

Date: 04/28/16

Effective June 1, 2016, pharmacy claims related to terminal illness for members in hospice will require billing through the hospice provider.

Hospice members will be identified based on hospice enrollment authorizations.
All drugs related to the terminal illness of the patient are covered by the hospice program and are included in the hospice daily rate.
Please request payment directly from the hospice provider.
Drugs not related to the terminal illness or related conditions for beneficiaries receiving hospice care require prior authorization for coverage by Sunflower Health Plan.

If you have questions about this bulletin or other provider resources, please contact our Customer Service Center at toll free 1-877-644-4623.