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Hospitals To Be Permitted Presumptive Eligibility Determination For More Medicaid Categories

As of January 1, 2014, hospitals participating in Medicaid will be permitted to make presumptive eligibility determinations for uninsured individuals seeking care who appear to qualify for their state’s existing Medicaid program. Hospitals will have this option whether or not the state has elected presumptive eligibility as a state plan option. Previously, 33 states that had implemented the option to do so could delegate presumptive eligibility decisions to hospitals for certain uninsured populations, such as pregnant women or children, to provide temporary care, while the state verifies the individual’s eligibility for Medicaid or the Children’s Health Insurance . . .

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