Kansas Family Medical Assistance
Manual (KFMAM)
Eligibility Policy - 4/23/2024
01000 >>> 01400 >>> 1408 >>> 1408.01
1408
1408.01 Qualified Hospitals and Qualified Entities - KDHE-DHCF is responsible for certifying all entities qualified to make Presumptive Eligibility decisions. Certain Medicaid enrolled hospitals and Safety Net Clinics have been designated Qualified Entities allowed to make presumptive eligibility decisions.
All entities must complete training and receive certification by KDHE-DHCF prior to making any determinations.
Presumptive Eligibility is determined through the Presumptive Eligibility (PE) Portal. Once entity staff have received training and are deemed certified, they will gain access to the PE Portal.
Qualified Hospital
A qualified hospital is a hospital that
(1) Participates as a Kansas Medicaid provider, notifies KDHE of its election to make presumptive eligibility determinations, and agrees to make presumptive eligibility determinations consistent with Kansas policies and procedures,
(2) Assists individuals in completing and submitting the full KanCare application and understanding any documentation requirements, and
(3) Has not been disqualified by KDHE.
Qualified Entity
A qualified entity is
(1) Healthcare providers, community-based organizations, schools, head start programs authorized by the state to screen for Medicaid and CHIP eligibility and immediately enroll adults, children, and pregnant women who appear to be eligible,
(2) Assists individuals in completing and submitting the full KanCare application and understanding any documentation requirements,
(3) Has not been disqualified by KDHE.