EE12
Presumptive Eligibility Applications
CMS-required outcome
The system receives Presumptive Eligibility (PE) applications from all approved entities in an automated manner and facilitates eligibility termination if no full Medicaid application is received by the end of the month following the month of PE determination.
Default metrics
- Number of PE applications received.
- Percentage of individuals disenrolled at the end of the PE period for failure to file a full application.
- Percentage of individuals who are determined eligible for Medicaid by the end of the PE period.
Regulatory sources
- For states, District of Columbia, Northern Mariana Islands, and American Samoa:
- - 42 CFR 435.1110