42 C.F.R. § 418.21
Duration of hospice care coverage—Election periods
(a) Subject to the conditions set forth in this part, an individual may elect to receive hospice care during one or more of the following election periods:
(1) An initial 90-day period;
(2) A subsequent 90-day period; or
(3) An unlimited number of subsequent 60-day periods.
(b) The periods of care are available in the order listed and may be elected separately at different times.
Notes of Decisions
Cited in 4
cases (3 in the last 5 years), 2018–2025 · leading case: Druding v. Care Alternatives, Inc., 346 F. Supp. 3d 669 (D.N.J. 2018).
Druding v. Care Alternatives, Inc., 346 F. Supp. 3d 669 (D.N.J. 2018). “§ 1395f(a)(7)(A) ; 42 C.F.R. § 418.21 (a). After a patient is initially certified by hospice by an attending physician and a hospice medical director, the patient need only be recertified for subsequent benefit periods by an attending physician or hospice medical director.”
Staten v. Chubb Grp. Ins. (N.D. Ala. 2021). “at 6–7 (citing 42 C.F.R. §§ 418.21 (a), 418.22(a)(4)(i)) (internal quotation marks omitted).”
United States of Am. v. Curo Health Servs. Holdings, Inc. (M.D. Tenn. 2022). “42 C.F.R. § 418.21 . A fresh COTI must be completed at the beginning of each election period, 42 C.”
Becerra (D. Or. 2025). “42 C.F.R. § 418.21 (a). During each period an individual receives hospice care, the hospice must certify that “the individual’s prognosis is for a life expectancy of 6 months or less if the terminal illness runs its normal course.”
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