ID H0845

Limits Medicaid presumptive eligibility determinations to qualified hospitals, requiring hospitals to notify the department within 5 business days of each determination and assist applicants with completing full Medicaid applications.

Presumptive eligibility ends on the last day of the following month if the applicant does not file a full Medicaid application; coverage continues until a final determination if an application is filed before that deadline.

Establishes a three-strike violation system: first violation results in written notice, second violation within 12 months requires mandatory staff training, and third violation within 12 months of the second disqualifies the hospital from making presumptive eligibility determinations.

Requires the department to notify hospitals of violations within 5 days and provide an appeals process, with hospitals bearing the burden of proving by clear and convincing evidence that standards were met.

Declared an emergency measure, effective July 1, 2026.