To: Hospital CFOs and Outreach/Enrollment Leads
From: Barbara Gorham, WSHA Policy Director, Access
Staff Contact: Barbara Gorham, 206-216-2512 (barbarag@wsha.org)
Subject: HCA to Implement Hospital Presumptive Eligibility in January
Purpose
The purpose of this bulletin is to notify you that the Washington State Health Care Authority (HCA) is now implementing “Hospital Presumptive Eligibility” (HPE) for Apple Health Enrollment. The HCA will offer trainings in January 2015 for any hospital that registers for the training by December 19, 2014.
HPE allows a hospital to enroll someone in Medicaid for up to 60 days with minimal information from the client. For example, if a client does not know their tax filing status, hospitals can enroll via HPE. Or if there is a glitch preventing enrollment using the Washington Healthplanfinder website, a hospital can enroll someone immediately via Hospital Presumptive Eligibility.
Applicability/Scope
Any hospital in the state of Washington that accepts Medicaid, receives training, and signs an HPE contract with the HCA is eligible to participate in HPE. The January 2015 trainings will be recorded and posted online for hospitals that decide to participate after December 19, 2014.
Recommendation
Hospitals should review the linked materials below regarding the HPE program and decide whether or not to participate. To begin Hospital Presumptive Eligibility as soon as possible, we recommend you register for the HPE trainings by December 19, 2014.
Background and References
States are required by the Affordable Care Act to implement Hospital Presumptive Eligibility in any state where hospitals request it. WSHA polled our members earlier this year and about two dozen hospitals indicated they wanted to have the option to use HPE to enroll people in Apple Health.
The HCA has released the following information for hospitals about the program and upcoming trainings.
