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MedicaidAdministrativeMedium impact

Changes to Hospital Presumptive Eligibility processes, effective immediately

Oregon Health Plan·OR·Provider
Effective date
Mar 24, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Authority has temporarily modified Hospital Presumptive Eligibility (HPE) application and termination processes to allow phone-based applications without face-to-face interviews, verbal signatures, and mail-based notices. Existing HPE coverage will not be terminated for failure to complete full applications or application denials during this emergency period.

Action Required

Action needed
Immediately: Billing and eligibility staff at qualified hospital HPE sites must update internal processes to accept phone-based applications and verbal signatures. Specifically: (1) Authorized HPE application processors must conduct verbal reviews of OHP 7260 applications with applicants and document verbal signatures in the signature line with notation; (2) Front desk/intake staff must route applicants to phone application process instead of requiring hospital visits; (3) Billing team must update follow-up procedures to mail approval/denial notices to applicant addresses rather than providing in-person; (4) Continue processing all other HPE procedures normally, including entering HPE end dates and full application due dates as the end of the following month. Do NOT terminate existing HPE coverage for incomplete applications or denials during this period. Contact HPE.program@dhsoha.state.or.us with questions. Failure to implement these changes will delay coverage determinations and create barriers to patient access during the emergency period.