Implementation Guide: Medicaid State Plan Eligibility Presumptive Eligibility Presumptive Eligibility by Hospitals
Guidance for the reviewable unit (RU) that describes the provisions under which hospitals determine presumptive eligibility (PE) for various groups of individuals, as described at 42 CFR 435.1110. Qualified hospitals may determine PE for groups of individuals described in the state plan, subject to the same requirements that apply to PE determinations made under the authority of 42 CFR 435.1102 and 435.1103, but regardless of whether the state elected to allow PE determinations under such sections.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 01, 2019
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