MedicaidAdministrativeHigh impact
Attention Hospice Provider Types 64 (Hospice) and 65 (Hospice, Long Term Care): Reminder Regarding Requirements for the Hospice Program Election Notice, Forms FA-92 and FA-93
Nevada Medicaid·NV · Palliative Care·Provider Announcement
Effective date
Sep 3, 2025
We identified it
Jun 21, 2026
Summary
Nevada Medicaid requires a newly signed Hospice Program Election Form (FA-92 or FA-93) for each hospice certification request. Previously signed forms cannot be reused for subsequent certification requests, and prior authorizations without newly signed forms will be pended back.
Action Required
Immediately: Hospice providers must obtain a newly signed FA-92 or FA-93 form for each certification request. Download current forms from Nevada Medicaid website. Update workflow to ensure fresh signatures for all prior authorization submissions. Failure to use newly signed forms will result in prior authorizations being pended back or technically denied.