ICWP and Hospice at the same time????

Yes, I have had patients in hospice who had what we here in Jersey call "waver programs". They are Medicaid programs that the patient who has a little too much income or property for Medicaid, but are still considered "poor" and have no other insurance. It may pay for care, supplies and case management by the county medicaid office. We also are told not to duplicate services. Which in Jersey means the home health aide, as the "case manager" for Medicaid would be a social worker, not a nurse. And it seems the waver programs only pay for about 4 hours of an aide, so if they come in the morning, ours goes in the afternoon. We also have patients who qualify for traditional Medicaid due to their income being below the minimum who have programs that we have to coordinate with. I feel it is no different that the person who has hospice paid for by Medicare and has a secondary insurance policy that pays for home care as some long term care policies do. There just has to be a coordination of benefits and no duplication of benefits.