<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".03" citation="COMAR 10.09.91.03" title_num="10" subtitle_num="09" chapter_num="91" heading="Requirements.">
  <paragraph num="A.">
    <text>A hospital eligible to make presumptive eligibility decisions shall:</text>
    <paragraph num="(1)">
      <text>Participate as a Maryland Medical Assistance Program provider in good standing; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Sign an agreement prepared by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>The agreement required under §A of this regulation shall require that the hospital:</text>
    <paragraph num="(1)">
      <text>Comply with Departmental policies and procedures supplied by the Department at the time of application and training;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Meet accuracy and timeliness standards established by the Department;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Submit a list to the Department of hospital employees who will attend presumptive eligibility training developed by the Department;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Prohibit employees who have not attended required trainings and passed a post-training test to make presumptive eligibility decisions; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Report all requested information on a form designated by the Department.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Before assisting an applicant in filing a presumptive eligibility application, the hospital employee shall:</text>
    <paragraph num="(1)">
      <text>Check the Department’s eligibility verification system to make sure the individual is not actively enrolled in the Maryland Medical Assistance Program;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide information concerning the full Medical Assistance application process to the individual applying for presumptive eligibility and assist or refer the applicant to an individual who can assist the applicant in completing a full Medical Assistance application;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Determine that the applicant has not:</text>
      <paragraph num="(a)">
        <text>Had a prior presumptive eligibility period within the last 12 months for the individual other than pregnant women; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Had a prior presumptive eligibility period during the current pregnancy for a pregnant woman.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The hospital employee shall fill out the presumptive eligibility application based on information supplied by the applicant.</text>
  </paragraph>
  <paragraph num="E.">
    <text>The hospital employee shall make a presumptive eligibility decision and sign the presumptive eligibility application based on the following information obtained pursuant to COMAR 10.09.91.05:</text>
    <paragraph num="(1)">
      <text>Residency;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Citizenship;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Family size and composition; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Gross family income.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>The hospital employee shall inform the individual in writing of the hospital’s presumptive eligibility decision which includes an explanation of the presumptive eligibility period.</text>
  </paragraph>
  <paragraph num="G.">
    <text>The hospital shall submit the presumptive eligibility application to the Department on the date of application completion to allow the individual to have temporary Medical Assistance coverage.</text>
  </paragraph>
  <paragraph num="H.">
    <text>The hospital shall:</text>
    <paragraph num="(1)">
      <text>Keep all written and signed presumptive eligibility applications on file for 6 years; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Make the file available to the Department upon request.</text>
    </paragraph>
  </paragraph>
</regulation>