For the initial 90-day period, the hospice must obtain written certification statements and oral certification statements from the medical director of the hospice or the physician member of the hospice interdisciplinary group, and the individual's attending physician, if the individual has an attending physician.
For subsequent periods, the only requirement is certification by the medical director of the hospice.
Resources:
https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-418/subpart-B/section-418.22