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CMS Releases Resources for Implementing Hospital Presumptive Eligibility

On Jan. 24, the Centers for Medicare & Medicaid Services (CMS) released new resources for implementing hospital presumptive eligibility (PE), including frequently asked questions (FAQs). In the FAQs, CMS clarified that hospitals “may implement PE with the support of third party contractors.” The agency also said hospitals may rely on third-party contractors to meet with consumers and help them complete PE applications. As of January 2014, hospitals may temporarily enroll in Medicaid patients who are likely to be eligible. The Affordable Care Act (ACA) expanded the role of hospitals in making presumptive eligibility determinations and expanded presumptive eligibility to parents and some adults.

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