Monday, August 26, 2013

Medicaid Presumptive Eligibility Hospital Toolkit Available

Under the Patient Protection and Affordable Care Act, hospitals have a new opportunity to help patients who are potentially eligible for Medicaid apply for health coverage.

How it works: Under the new Medicaid “presumptive eligibility” regulations, hospitals can temporarily enroll patients in Medicaid coverage at the point of service with a few basic pieces of information such as income and household size. This not only will help patients get connected to needed health coverage, but also will help hospitals receive payment for services provided before a full Medicaid determination is made. A hospital can elect to make such determinations without regard to whether the state chooses to expand its Medicaid program or has an established presumptive eligibility program.

To help hospitals get started and learn more about making presumptive eligibility determinations, Enroll America has developed a web-based toolkit. Enroll America is a nonpartisan organization whose mission is to enroll uninsured Americans in available health coverage. Click here to access the toolkit.

For more resources on ways hospitals can get involved in health insurance outreach and enrollment, visit AHA’s new website:

If you have questions, contact Molly Collins Offner, AHA director of policy development, at

Click here for a PDF version of this Special Bulletin.

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