The Medicaid Hospital Based Presumptive Eligibility 医疗补助资格的医院为基础的推定.pptxVIP

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2017-04-10 发布于上海
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The Medicaid Hospital Based Presumptive Eligibility 医疗补助资格的医院为基础的推定.pptx

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The Medicaid Hospital Based Presumptive Eligibility 医疗补助资格的医院为基础的推定

The Medicaid Hospital Based and Pregnancy Presumptive Eligibility (PE) Program Nebraska Department of Health and Human Services Division of Medicaid and Long-Term Care 1 In this training, the following will be covered: Overview of the Hospital Presumptive Program Overview of the Pregnant Women’s Presumptive Program How to Become a Provider Terms and Definitions Eligibility Requirements Household/Unit Size Income Filing an Application Presumptive Eligibility Determination process Contents 2 What is Hospital Based Presumptive Eligibility? With new Medicaid regulations taking effect 1-1-2014, hospitals will have the option to participate in the Hospital Based Presumptive Eligibility Program. This program allows qualified hospitals to make a presumptive Medicaid eligibility determination for individuals based on preliminary declared information (income, citizenship/immigration status, and residence). Individuals approved will be eligible for Medicaid services during a temporary presumptive time period. Hospital Presumptive Overview 3 Frequency Limitations: Presumptive eligibility determinations are limited to no more than one period within two calendar years per person. A pregnant woman may be authorized for presumptive eligibility once per pregnancy. (Note: A presumptively eligible pregnant woman is eligible for ambulatory prenatal care only.) Hospital Presumptive Overview 4 Qualified Entity Responsibilities: Notify the appropriate individual at the time a determination regarding presumptive eligibility is made, in writing or orally if appropriate, of such determination, that – If a Medicaid application on behalf of the eligible individual is not filed by the last day of the following month, the individual’s presumptive eligibility will end on that last day. If a Medicaid application on behalf of the eligible individual is filed by the last day of the following month, the individual’s presumptive eligibility will end on the day that a decision is made on the Medica