JubalMed
Relatedness42 C.F.R. § 418.24

The whole chart, read. Every call, reasoned. Your IDG signs.

Jubal Med reads every record and proposes related, unrelated or physician review for each diagnosis, medication and supply, with its rationale, its chart cite and its HOPE Section I category. Your team changes what it disagrees with and signs. The addendum is built from the signed worksheet.

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Jubal Med
The Jubal Med desktop app: the chat reports the gate and a second model's review, then that the relatedness worksheet is ready, beside the worksheet document with each condition, its HOPE category and a cited rationale.
The worksheet, ready. On the left, the checks it passed on the way, and the one gap it found: no signed election statement in the records.Desktop app · fictional hospice and patient
Every row, with its reason

Nothing on the chart is quietly left off.

Every listed item
Each diagnosis, medication and supply on the record gets a row, or is left off for a stated reason: stopped, resolved, a duplicate, never started.
A cited rationale
Each call says why, and names the record and page it rests on, so a reviewer can check it in seconds.
A second opinion
A model from a different vendor audits the draft. Anything still in dispute goes to physician review, never quietly decided.
Starts from last time
The next worksheet begins from the last signed one. A call that flips goes to physician review, and stays there until the IDG decides.
Your contractor's LCDs
Regulatory notes cite only the LCDs that bind your hospice's state.
Jubal Med
Worksheet rows: each condition with its ICD-10 code, related, the HOPE category, and a rationale citing the record and page.
Each rationale ends with its sources, such as "CTI 09/29/2026; JVH eval p.1".
From worksheet to addendum

Inside the five days, with time to spare.

Since October 1, 2026, the addendum is required for every election, not only when a patient asks. Jubal Med keeps the clock and drafts the form from the signed worksheet.

  1. Day 0Election recordedThe five-day addendum clock starts on the patient's compliance list.
  2. MinutesWorksheet draftedFrom every record on file, and audited by a second model.
  3. Your IDGReviewed and signedYour team decides every call it disagrees with.
  4. By day 5Addendum furnishedIn plain language, as Word or PDF, filed with the election statement.
What the rule says

Within 5 days of the election's effective date, furnished and filed with the election statement.

Within 3 days of a plan-of-care change that changes a determination, updated.

All related still gets an addendum. CMS: it is not a blank form, and plain language is required.

Not due if the patient dies, revokes or is discharged before it would be. A signature acknowledges receipt; a refusal is noted on the form.

91 FR 49118 (Aug 3, 2026), effective Oct 1, 2026 · 42 C.F.R. § 418.24(b)(6), (c), (d)
Jubal Med
The patient's compliance list in the desktop app, with the election statement addendum due October 1 and its Build step.
The addendum on the patient's compliance list: its due date counted from the election, and Build once the worksheet is signed.
Title card: Meet Jubal Med, a 3-minute demo.3:07
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See a worksheet built from a full chart

Fourteen conditions on a fictional patient with pancreatic cancer, each proposed with its HOPE category and cited rationale, then audited by a second model.

Run your next admission through it, and see the addendum on day one.

14-day free trial, no card. Every request is read and approved by a person.

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