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Does my state have to implement hospital presumptive eligibility (PE)?

Yes, under the law, all states must implement hospital PE to include all qualifying hospitals willing to abide by state policies and procedures. States have discretion in how they operate hospital PE to ensure that appropriate PE determinations are being made. In order to be considered a qualified entity, under the regulation at 42 CFR 435.1110(b)(1), the hospital must agree to make presumptive eligibility determinations consistent with state policies and procedures, and the state can and should exercise oversight to ensure proper administration of hospital PE. To fulfill this responsibility, states must provide qualified entities with information on relevant state policies and procedures and information on how to fulfill their responsibilities in making presumptive eligibility determinations.

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Date
FAQ ID
91726
FAQ Question
Does my state have to implement hospital presumptive eligibility (PE)?