Medicaid providers must make presumptive eligibility (PE) determinations for Nebraska Medicaid consistent with DHHS policies and procedures for Qualified Hospitals and Entities, in accordance with 42 CFR 435.1110, HHA criteria guidelines, as well as state regulations as of January 1, 2014, at 477 NAC 1-000 through 477 NAC 29-000. A provider must be enrolled with Medicaid prior to making PE determinations. In order to become accepted, the Medicaid provider must fulfill the following requirements.
In accordance with Nebraska regulations all PE determinations shall be indicated on a DHHS Presumptive Eligibility Form and electronically sent to DHHS.MedicaidPE@nebraska.gov. The accepted provider shall provide each beneficiary with an agency approved application for Medicaid and Insurance Affordability programs.