Description
MassHealth is seeking applications from Massachusetts hospitals that wish to become qualified to make Hospital‑Determined Presumptive Eligibility (HPE) determinations for Medicaid‑eligible individuals. Hospitals must sign a non‑financial contract, submit an application, and certify compliance with Executive Order 504. Certified Application Counselors (CACs) must be trained, maintain records for at least seven years, and meet performance metrics (e.g., ≥ 75 % of HPE‑determined individuals must submit a full MassHealth application). The program is open‑ended (rolling enrollment) and does not provide direct monetary compensation; the benefit is the authority to provide temporary Medicaid coverage and associated administrative support.
• Eligible entities: Massachusetts hospitals (including satellite clinics) that are already MassHealth providers.
• Required deliverables: Signed contract (Appendix A), completed application (Appendix B), EO 504 certification (Appendix C), and copies of each.
• Obligations: Use trained CACs, attend EOHHS‑provided training, submit performance data, protect personal health information, retain records ≥ 7 years, and cannot delegate eligibility decisions.
• Timeline: RFA posted March 21 2014; conference call March 28 2014; question deadline March 31 2014; earliest contract effective April 7 2014; rolling enrollment thereafter.
• No budget or payment is attached; the contract is non‑financial.