Implementation of Hospital Presumptive Eligibility

Beginning in January 2014 all states must implement hospital PE and ensure that hospitals that participate in the Medicaid program can begin making PE determinations to provide temporary Medicaid coverage to individuals who qualify including children, pregnant women, parents, individuals formerly in foster care, and, if applicable in a state, adults covered under the new low-income adult eligibility group. CMS released this set of frequently asked questions for states and stakeholders regarding hospital PA. It discusses questions on the application process, the eligible populations, information on the qualified entities that can make hospital PE determinations, qualification standards for participating hospitals, and the federal matching funds available.