PA Revises Guidelines for Medicaid Presumptive Eligibility

The Pennsylvania Department of Human Services has revised its guidelines for hospitals qualified to make presumptive eligibility determinations for potentially Medicaid-eligible patients who seek services but are uninsured.

Bookshelf with law booksThe revisions are described in Medical Assistance Bulletin 01-15-08, “Revised Presumptive eligibility as Determined by Hospitals,” which was issued on February 24 but is retroactive to January 1.

In support of that new guidance the state also has issued an addendum for providers outlining their responsibilities and a worksheet for hospitals to use in determining eligibility.

Filed in Medical Assistance Bulletin, Pennsylvania Medicaid policy.

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