CHA News Article

ACA Hospital Presumptive Eligibility Program Resources Available for Hospitals
Links to webinars, FAQs, forms and helpful websites

Many resources are available for hospitals interested in participating in the Hospital Presumptive Eligibility (PE) program. As of Jan. 1, 2014, the Affordable Care Act (ACA) gives hospitals a unique new opportunity to use presumptive eligibility to provide temporary, full-scope Medi-Cal benefits for up to two months to individuals newly eligible for Medi-Cal under the ACA (restricted scope Medi-Cal benefits for pregnant women). The determination will be conducted in real time and will be based on income, household size and state residency. Presumptive eligibility will be granted for up to two calendar months; the eligibility period will begin the first day of the month the Hospital PE application is submitted and will end the last day of the following month. Any hospital that participates in the Medi-Cal program may apply to participate, and any entity on a hospital’s license may conduct Hospital PE determinations.

In order to participate, hospitals must:

  • Agree to the program requirements as prescribed in the Hospital Presumptive Eligibility Program Provider Election Form and Agreement (see link below);
  • Complete, sign and return the agreement to the Department of Health Care Services (DHCS); and
  • Complete the hospital PE training program, an online training environment that hospitals will be able to access after they submit the agreement to DHCS.

The following resources may be helpful to hospitals:


Fact Sheets:

Webinar Recordings:

For more information, visit the DHCS website at Questions about the Hospital PE program may be submitted to DHCS at