Question:
Can a NP sign the certification of terminal illness? If they cannot, where is the official guidance stating this? We have always required that an MD must sign; however, we have a physician from a Physician Rounding Group who is adamant that their NP should be able to sign these.

Response:
“The certification should be based on the clinical judgment of the hospice medical director (or physician member of the interdisciplinary group (IDG), and the patient's attending physician, if he/she has one. Nurse practitioners and physician assistants cannot certify or recertify an individual is terminally ill. If the patient's attending physician is a nurse practitioner or a physician assistant, the hospice medical director or the physician member of the hospice IDG certifies the individual as terminally ill.”

https://www.cgsmedicare.com/hhh/coverage/Coverage_Guidelines/CERT_ReCERT_Requirements.html