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Hospital Presumptive Eligibility (HPE) Flexibilities due to COVID-19

Originally published April 2, 2020 and updated on April 8, 2020

Due to the ongoing response to coronavirus disease 2019 (COVID-19), the Department of Healthcare Services (DHCS) is approving immediate enrollment flexibilities for Presumptive Eligibility (PE) providers to limit potential exposure to COVID-19.

Hospital Presumptive Eligibility (HPE)
Enrolling Providers can utilize telephonic signatures for HPE Applications, noting in the case file “COVID-19 protocol.” If the individual is not at the hospital and is not experiencing an urgent health event which requires immediate care, providers should suggest to the individual to apply online using the Covered California website to establish ongoing eligibility for Medi-Cal or Covered California. Providers may also obtain an Authorized Representative form for the HPE applicant, which allows a provider to act on behalf of the applicant and provide the required information to assist with the enrollment of the patient in HPE, thereby minimizing direct contact with the patient and promoting physical distancing.

Process
In order to accept a telephonic signature, the following procedure must be followed:

  • Read the consent language, “By signing, I declare that what I say below is true and correct.” aloud to the individual/Authorized Representative as it is stated on the signature page of the HPE Application:
    1. 1.  I have read and understood this HPE Medi-Cal Application.

      2.  The information I provided is true, correct, and complete.

      3.  I understand that I must complete and submit the insurance affordability application by the end of my PE period in order to be eligible for continued coverage.

      4.  I have received the insurance affordability application.

  • Ask that the individual/Authorized Representative verbally acknowledge their consent
  • In the signature line, type “Verbal consent – COVID-19”
  • Be sure to document and keep documentation for all verbal consent obtained

Questions concerning HPE Flexibilities should be sent to DHCSHospitalPE@dhcs.ca.gov.