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AHA recommends changes to Medicaid/CHIP enrollment rule

February 21, 2013

The AHA today expressed concern that hospitals, which are eager and willing to help enroll their patients in Medicaid, may be discouraged from doing so given the Centers for Medicare & Medicaid Services' proposed implementation of the presumptive eligibility determinations under the Patient Protection and Affordable Care Act. Commenting on the agency's proposed rule that would streamline the enrollment process for Medicaid, the Children's Health Insurance Program and insurance exchanges, the association urged CMS to issue guidance specifying how states must work with hospitals that elect to make presumptive eligibility determinations, saying the AHA is "concerned that hospitals will not have sufficient information to effectively determine Medicaid eligibility on a presumptive basis." Additionally, the letter urged CMS to clarify that coverage restrictions on Institutions for Mental Diseases do not apply to the Medicaid expansion population, among other recommendations.