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:
- model agreements between the state and hospitals that outline presumptive eligibility requirements
- a model training template for states to use with hospitals
- a model application for hospitals
- frequently asked questions
Please contact Xiaoyi Huang, director of policy, at firstname.lastname@example.org or 202.585.0127 with questions.