Are states required to allow hospitals to operate Presumptive Eligibility (PE)?

States are not uniformly required to allow hospitals to operate Presumptive Eligibility (PE); rather, they have the discretion to implement such programs. Presumptive Eligibility enables certain hospitals to determine eligibility for Medicaid on a temporary basis for individuals seeking immediate health care services. By adopting the option of PE, states aim to expand access to medical care for individuals who may not fully understand their eligibility status or need immediate services.

When hospitals are enabled to provide PE, it facilitates rapid access to health coverage for eligible individuals, capturing those who might otherwise delay or forgo necessary medical treatment. However, this program's implementation is left to the states, allowing them to decide whether to adopt PE and under what conditions. Thus, the correct choice recognizes the voluntary nature of this decision by states in offering Presumptive Eligibility within their Medicaid programs.