Current through Register Vol. 51, No. 19, September 20, 2024
A. A hospital
eligible to make presumptive eligibility decisions shall:
(1) Participate as a Maryland Medical
Assistance Program provider in good standing; and
(2) Sign an agreement prepared by the
Department.
B. The
agreement required under §A of this regulation shall require that the
hospital:
(1) Comply with Departmental
policies and procedures supplied by the Department at the time of application
and training;
(2) Meet accuracy
and timeliness standards established by the Department;
(3) Submit a list to the Department of
hospital employees who will attend presumptive eligibility training developed
by the Department;
(4) Prohibit
employees who have not attended required trainings and passed a post-training
test to make presumptive eligibility decisions; and
(5) Report all requested information on a
form designated by the Department.
C. Before assisting an applicant in filing a
presumptive eligibility application, the hospital employee shall:
(1) Check the Department's eligibility
verification system to make sure the individual is not actively enrolled in the
Maryland Medical Assistance Program;
(2) Provide information concerning the full
Medical Assistance application process to the individual applying for
presumptive eligibility and assist or refer the applicant to an individual who
can assist the applicant in completing a full Medical Assistance application;
(3) Determine that the applicant
has not:
(a) Had a prior presumptive
eligibility period within the last 12 months for the individual other than
pregnant women; or
(b) Had a prior
presumptive eligibility period during the current pregnancy for a pregnant
woman.
D.
The hospital employee shall fill out the presumptive eligibility application
based on information supplied by the applicant.
E. The hospital employee shall make a
presumptive eligibility decision and sign the presumptive eligibility
application based on the following information obtained pursuant to COMAR
10.09.91.05:
(1) Residency;
(2) Citizenship;
(3) Family size and composition; and
(4) Gross family income.
F. The hospital
employee shall inform the individual in writing of the hospital's presumptive
eligibility decision which includes an explanation of the presumptive
eligibility period.
G. The
hospital shall submit the presumptive eligibility application to the Department
on the date of application completion to allow the individual to have temporary
Medical Assistance coverage.
H. The
hospital shall:
(1) Keep all written and
signed presumptive eligibility applications on file for 6 years; and
(2) Make the file available to the Department
upon request.
