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Resources for Implementing Hospital Presumptive Eligibility

As of Jan. 1, the Affordable Care Act (ACA) allows hospitals to temporarily enroll patients in Medicaid using hospital presumptive eligibility, which is based on a few basic pieces of information such as income and household size. States must submit Medicaid state plan amendments that establish presumptive eligibility by March 31. To help hospitals implement presumptive eligibility, the Centers for Medicare & Medicaid Services (CMS) developed several resources, including the following:

In addition, Enroll America, with help from America’s Essential Hospitals, released a hospital presumptive eligibility toolkit earlier this year.

Please contact Xiaoyi Huang, director of policy, at or 202.585.0127 with questions.


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