Presumptive Eligibility
A growing trend in hospital and health system financial assistance programs is the incorporation of presumptive eligibility screenings for charity care. Presumptive eligibility refers to an automated process of analyzing readily available financial and other data to approximate a patient’s financial need. Implementing these presumptive eligibility screenings provides numerous benefits to both patients and the hospitals that serve them. Technological improvements and an increase in thirdparty solutions have made presumptive eligibility programs more accurate and easier to implement. This fact sheet provides hospitals and health systems with an overview of key considerations for implementing presumptive eligibility for charity care. The AHA encourages all members to consider whether some form of presumptive eligibility for charity care makes sense for their organization.
The Centers for Medicare & Medicaid Services recently issued new Frequently Asked Questions to aid the Medicaid program and Children’s Health Insurance Program in their response to the COVID-19 pandemic.
The AHA, American Nurses Association and American Medical Association today urged the president to declare the novel coronavirus (COVID-19) outbreak a disaster or emergency under the Stafford Act or the National Emergencies Act.
Presumptive eligibility determination, allows hospitals to temporarily enroll patients into Medicaid coverage with a few basic pieces of information, such as income and household size, at the point of service.
Webinar: Hospital-based Medicaid Presumptive Eligibility and Enrollment
Hospital leaders should encourage and actively participate in 1) developing a community-wide and/or regional plan for persons with behavioral health disorders and 2) coordinating community agencies addressing behavioral health needs.
Recommendation 3Hospital leaders should encourage and actively participate in 1) developing a community-wide and/or regional plan for persons with behavioral health disorders and 2) coordinating community agencies addressing behavioral health needs.Recommendation 3aHospital leaders should work with…