Frequently Asked Questions

The latest date by which the SPA must be filed in order to meet the required effective date of January 1, 2014 is March 31, 2014 (the end of the quarter in which the policy will take effect). However, the hospital PE provision took effect on January 1 and every state is expected to implement this provision in compliance with the law.

CMS has provided a series of guidance and tools designed to assist states in implementing hospital presumptive eligibility, including proposed and final regulations, several all-state SOTA calls and webinars, and a model set of training materials for states to use in educating hospitals about PE. In addition, CMS convened an "affinity group" of a dozen states designed to share questions and best practices in detail as states were designing their hospital PE policies. These discussions were informed by several internal and external subject matter experts in the field of PE who offered suggestions about developing training materials, simplifying applications, and considering standards for states to use in measuring hospital performance and ensuring accountability. CMS is available to provide ongoing technical assistance and to review preliminary SPA proposals to help ensure that states are implementing hospital PE properly. States that wish to discuss mitigation approaches for implementing hospital PE should reach out through the SOTA process.

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FAQ ID:91731