008.05 RESPONSIBILITIES OF QUALIFIED ENTITIES.

An entity qualified to make presumptive eligibility determinations must: (A) Notify the appropriate individual at the time a determination regarding presumptive eligibility is made, in writing or orally if appropriate, of such determination, and of the presumptive eligibility period, and (i) If a Medicaid application on behalf of the eligible individual is not filed by the last day of the following month, the individual’s presumptive eligibility will end on that last day; (ii) If a Medicaid application on behalf of the eligible individual is filed by the last day of the following month, the individual’s presumptive eligibility will end on the day that a decision is made on the Medicaid application; (iii) If the individual is not determined presumptively eligible, the qualified entity must notify the appropriate individual of the reason for the determination and he or she may file an application for Medicaid with the Department; (B) Provide the individual with a Department approved application for Nebraska Medicaid; (C) Notify the Department the individual is presumptively eligible within five working days from the date the determination is made; and (D) Refrain from delegating the authority to determine presumptive eligibility to another entity.