Qualified Hospital Presumptive Eligibility Processes

A qualified hospital must have a Memorandum of Understanding (MOU) with the Department and follow all standards and processes agreed to in the MOU. (7-1-24) 01. Acceptance of Application. The qualified hospital accepts the request for services in the same manner as all applications for assistance are accepted. (7-1-24) 02. Standards and Processes. The presumptive eligibility determination must be based on standards and processes provided by the Department. (7-1-24) 03. Assistance to Applicant. The qualified hospital must assist the applicant in completing the Department's application process. (7-1-24) 04. Qualified Hospital Staff. Only qualified hospital staff who are trained in presumptive eligibility standards can make a presumptive eligibility determination. (7-1-24) 05. Notice to Applicant. The qualified hospital or the Department will provide notice to the applicant within two (2) business days on the presumptive eligibility determination. (7-1-24) 06. Notice and Hearing Rights. Presumptive eligibility decisions are not appealable and do not have hearing rights under the Title XIX Medicaid program. (7-1-24) 07. Number of Presumptive Eligibility Periods Allowed. Only one (1) presumptive eligibility period is allowed per applicant in any twelve (12) month period. (7-1-24) 547. -- 599. (RESERVED) CASE MAINTENANCE REQUIREMENTS (Sections 600-701)