Ohio's statewide Presumptive Eligibility (PE) initiative provides uninsured residents with the opportunity to receive immediate health care services through Medicaid if they are presumed to be eligible. Individuals who qualify through PE will then be provided with the information to apply for full Medicaid coverage.
Hospitals and Federally Qualified Health Centers (FQHCs) are eligible to participate in Ohio's PE initiative. To become a Qualified Entity (QE), providers are required to complete a couple of steps.
Provider training is essential in determining eligibility for presumptively eligible individuals. Proper training ensures the effective follow through of full Medicaid application processing and that all consumer information is successfully entered into the MITS portal.
Training Guide: How to use the Presumptive and Deemed Eligibility Portal
Qualified entities will be required to sign an acknowledgement form that will specify the responsibilities and obligations associated with being authorized to make presumptive eligibility determinations. Statewide training for providers’ MITS portal administrators will be required and administered by state staff.
After reading the training guide posted above, download the Acknowledgement Form. Print, sign and scan the document and email a PDF to medicaid_provider_update@medicaid.ohio.gov.
Acknowledgement Form Questions: Contact medicaid_provider_update@medicaid.ohio.gov
Policy Questions: Submit 'Quaified Entity Policy Email Template' to pequestions@medicaid.ohio.gov
Technical Questions: Submit 'Qualified Entity Technical Email Template' to DASOhioIE.Maintenance@DAS.ohio.gov
PE: Information for Qualified Entities System Notification for Qualified Entities
