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Revision 26-2; Effective June 1, 2026
Federal 1115 waiver requirements dictate that the STAR+PLUS Home and Community Based Service (HCBS) program provide the services needed to allow the member to live safely in the community. These services exclude hospice. Hospice services may be authorized with STAR+PLUS services or the STAR+PLUS HCBS program.
Hospice services may be delivered in a variety of settings, including nursing facilities (NFs). STAR+PLUS members must not be denied services or disenrolled due to receipt of hospice services. Hospice provides services for terminal illness that are not available under the STAR+PLUS program. For example, hospice providers can administer pain control medications that are not available to STAR+PLUS providers.
NF hospice services can be identified in the Service Authorization System Online (SASO) as service group (SG) 8, service code (SC) 31. The NF counter is activated by non-hospice NF authorizations, which appear in SASO as SG1/SC1 or SG1/SC3.