MedicaidCoverageHigh impact
Changes to Presumptive Eligibility Based on Immigration Status
Nebraska Medicaid·NE · Emergency Medicine·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Oct 4, 2026
Summary
Effective October 1, 2026, Nebraska Medicaid is restricting presumptive eligibility (PE) to individuals with eligible citizenship or immigration status (U.S. citizens, nationals, LPRs, Cuban-Haitian Entrants, and COFA migrants), with exceptions for pregnant women and children under 18 with valid legal status. PE providers must obtain attestation of eligibility status but are not required to verify documentation; applicants attesting to ineligible status must be denied PE.
Action Required
By October 1, 2026: Billing and front-desk staff must update PE intake procedures to require applicants to attest to their citizenship or immigration status. Update all PE determination forms and workflows to reflect the new eligible statuses (U.S. citizens, nationals, LPRs, Cuban-Haitian Entrants, COFA migrants, and pregnant women/children under 18 with valid legal status). Train all PE providers on the updated eligibility criteria. Implement a clear denial protocol for applicants who attest to ineligible status. Update EMR/billing system templates to capture citizenship/immigration status attestation. Notify all PE-authorized hospital departments of the change. Reference updated DHHS Medicaid PE Training materials (Slides 21, 31, 32) and the S1 Citizenship and Eligible Non-Citizens document. Failure to implement proper attestation procedures and denial protocols may result in improper PE determinations and subsequent claim denials or compliance issues.