Page 4

Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued June 20, 2023

Page 4 of H-3200 Replacing September 6, 2016 Revised/added text indicated by underscore Deleted text indicated by “**”

 Speaking with an on-site certified application counselor, if there is a certified application center on-site;  Referral to the nearest certified application center if there is not one on-site;  Applying on-line;  Applying via the customer service hotline at (888) 342- 6207; or  Visiting the nearest Medicaid office.

H-3240.4 HPE NOTICES

BHSF Form 1-HPE, issued at the time of HPE certification by the HPEQE, shall also serve as the termination notice. No advance notice or appeal rights are granted when terminating HPE coverage.

H-3240.5 MEDICAID RESPONSIBILITY UPON RECEIPT OF HPE DETERMINATION

Review of HPE Assessment

The HPE assessment is complete if it contains basic beneficiary information, HPE representative signatures, and dates. . If the assessment contains enough information for certification, enter the HPE certification immediately on LaMEDS. If the assessment does not contain enough information for certification, contact the beneficiary to secure the information and make a notation in the case notes.

Note: Medicaid payments made as a result of an erroneous Presumptive Eligibility (PE) determination by the HPEQE are not considered overpayments.

HPE eligibility decisions are not subject to Quality Control review.