MedicaidAdministrativeLow impact
BT2026100: Evaluation time frames set for qualified providers determining presumptive eligibility
Indiana Medicaid (IHCP)·IN·Provider Bulletin
Effective date
Jul 1, 2026
We identified it
Jun 18, 2026
Summary
Indiana Health Coverage Programs has clarified that performance standards for presumptive eligibility determinations now apply to all qualified providers, not just hospitals. The first evaluation period for nonhospital qualified providers will be Q3 2026 (July 1 to September 30), while hospitals will still be evaluated starting Q1 2026.
Action Required
By July 1, 2026: Nonhospital qualified providers making presumptive eligibility determinations must ensure compliance with performance standards outlined in IHCP Bulletin BT2025128. Review previous bulletin BT2025128 for specific performance requirements. Contact presumptiveeligibility@fssa.in.gov with questions before the evaluation period begins.