Provider Member - Number of patients served:
Provider Members shall be any association licensed by their state or certified by Medicare to provide hospice care. Membership is based on Medicare Provider #. Each provider number must be separate membership. Full voting rights.
Annual Due are calculated by the total # of patients served in 2010 per DHSS Hospice Statistical Report (Line 93m total patients served from all payor sources) X $6.00 per patient. NOTE minimum dues $420 and maximum dues $3600.
Associate Member (indicate type of Associate Membership)
Associate Member shall be any association or institution which is not eligible for membership as a provider member, but which supports the purpose of the Missouri Hospice & Palliative Care Association. Non-voting member.
Annual Dues $300
Developing Hospice Membership- any association pending licensure by their state or certification by Medicare to provide hospice care.
Professional Membership – any institution which support the purpose of Missouri Hospice and Palliative Care Association.
Palliative Care Membership
any association providing care within a facility, a department of a facility, an outpatient clinic or any other health care setting primarily focused on providing palliative care services.Annual Dues $420.00
Individual Member
Individual Members shall be any person interested in the hospice concept of care. Non-voting member. Annual Dues $60
Total:
