Mandatory Presumptive Eligibility Determined by Qualified Hospitals

Mandatory Presumptive Eligibility Determined by Qualified Hospitals A. Qualified hospitals are allowed to determine presumptive eligibility for individuals eligible for Medicaid in certain Medicaid coverage groups, referred to as Hospital Presumptive Eligibility (HPE). 1. Qualified hospitals are to immediately enroll patients in Medicaid who are determined eligible for Medicaid by authorized hospital staff. 2. HPE provides temporary Medicaid eligibility but also allows access to continuing Medicaid coverage provided the HPE decision includes filing a full Medicaid application. B. Medicaid populations eligible for HPE decisions include children up to age nineteen (19), pregnant women, low income parents or caretaker relative(s), former foster children and certain women with breast or cervical cancer. C. The Division of Medicaid is responsible for HPE Medicaid in conjunction with qualified hospitals that certify HPE eligibility.