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Attention Hospital Presumptive Eligibility and Pregnancy Presumptive Eligibility Providers: Updated Immigration Rules for Hospital & Pregnancy Presumptive Eligibility (PE) Effective October 1, 2026
Nevada Medicaid·NV · OB-GYN, Emergency Medicine·Provider Announcement
Effective date
Oct 1, 2026
We identified it
Sep 17, 2026
Summary
Effective October 1, 2026, Nevada Medicaid is restricting Hospital Presumptive Eligibility (PE) and Pregnancy PE eligibility based on federal immigration law changes (H.R.1 Section 71109). Only specific non-citizen groups—including LPRs meeting the 5-year bar, Cuban/Haitian entrants, COFA migrants, and those qualifying under CHIPRA 214—will remain eligible. Previously eligible groups (refugees, asylees, humanitarian parolees, TPS holders, trafficking victims, VAWA self-petitioners) will lose PE eligibility starting October 1, 2026, unless they qualify under alternative categories.
Action Required
By September 30, 2026: Billing and PE certification staff must update eligibility verification procedures to reflect new immigration status requirements. (1) Remove the following groups from automatic PE approval: refugees, asylees, humanitarian parolees, withholding of deportation holders, TPS holders, trafficking victims, VAWA self-petitioners, and conditional entrants. (2) For non-citizen applicants who do not qualify under the new federal categories, PE-certified staff must check CHIPRA 214 eligibility (lawfully residing children under 19 and lawfully residing pregnant women). (3) Update PE enrollment workflows and checklists to document immigration status category at time of eligibility determination. (4) Train front desk and eligibility staff on the new qualified categories. (5) Coordinate with your state PE portal administrator (nvhaee@nvha.nv.gov) for system updates if needed. Failure to apply correct eligibility rules will result in improper PE certifications, claim denials, and potential compliance issues.