Which components of the single, streamlined application are relevant for hospital PE and can or should be required for hospital PE determinations?

As noted above, states have many different options for developing and administering the presumptive eligibility application. States are not required to use a written application for hospital PE; they can permit qualified entities to ask the applicant for the information needed to make a PE determination and be accountable for accurately recording the information provided. States can also choose to use a written application for hospital PE. If a state requires the use of the single, streamlined application for hospital PE, it must denote which fields must be filled out in order for PE to be determined, meaning that the PE determination will be denied or delayed if this information is not provided by the applicant. The state cannot require the full Medicaid application be filled out in order to receive a PE determination. Questions that are not related to making a PE determination cannot be required (e.g. race and ethnicity).

If the state intends to use a separate application designed specifically for hospital PE, the questions must be limited to those needed by the qualified hospital to make a PE determination. CMS is available to provide technical assistance on the application questions that are necessary and that cannot be required for hospital PE purposes.