                                 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.