FAQ Directory: HEDIS

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7.16.2018 General Guidelines Does a member enrolled in palliative care meet criteria for the hospice exclusion outlined in General Guideline 17?

Palliative care is not the same as hospice care because it can begin when a patient is diagnosed or is undergoing treatment and may not indicate being near end of life. The hospice exclusion requires evidence that the member is receiving hospices services. Documentation that a member is in palliative care is not part of the exclusion.

HEDIS 2019