Qualified Hospital (QH) Presumptive Eligibility

Florida Medicaid enrolled hospital providers may elect to make presumptive eligibility determinations in accordance with federal law and state policy.

Qualified hospitals (QH) may make presumptive eligibility determinations for:

Provider Qualifications

Hospitals must meet the following qualifications in order to become qualified to determine presumptive eligibility:

Updates


Qualified Hospital Presumptive Eligibility (QHPE) Certificate Training - June 2018 [963KB PDF] Posted June 19, 2018

Use the Presumptive Eligibility Worksheet [261KB PDF] to assist when making PE determinations. Posted February 13, 2017

Presumptive Eligibility Income Limits – Effective June 2018 [80KB PDF]

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Florida Medicaid enrolled providers electing to make Presumptive Eligibility determinations must first renew their Medicaid Provider Agreement.

Institutional Medicaid Provider Agreement for QH Electing to Make Presumptive Eligibility Determinations [249KB PDF]

QHs must submit the INSTITUTIONAL PROVIDER AGREEMENT & ELECTION TO MAKE PRESUMPTIVE ELIGIBILITY DETERMINATIONS AS A QUALIFIED HOSPITAL to:

QH Enrollment Coordinator
Health Facilities and Ancillary Services
2727 Mahan Drive, Mail Stop 20
Tallahassee, Florida 32308

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