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Manual Enrollment for PE4PW is Discontinued

August 13, 2019

Effective October 31, 2018, the Department of Health Care Services (DHCS) has discontinued the manual (paper) enrollment process for the Presumptive Eligibility for Pregnant Women (PE4PW) program. Claims for services provided on or after January 1, 2019, submitted with the paper MC 263 PE Proof of Eligibility identification card are not reimbursable by Medi-Cal.

MC 263 PE For Pregnancy

If a recipient presents this type of ID for services, the provider must inform them that the ID is invalid and the recipient can locate a provider to enroll them electronically by visiting the Presumptive Eligibility for Pregnant Women page of the DHCS website.

Recipients enrolled through the electronic PE4PW web page will have a printed Immediate Need card and a record in the Med-Cal Eligibility Data System (MEDS). Providers should check eligibility before providing services.

Medi-Cal providers who provide prenatal care are encouraged to apply to become a Qualified Provider (QP) by completing the Qualified Application for Presumptive Eligibility Participation and taking the required PE4PW Computer Based Training (CBT). Information about the PE4PW program is available on the Presumptive Eligibility for Pregnant Women page of the Medi-Cal website.

QPs using the manual enrollment process must discontinue use of the paper Presumptive Eligibility for Pregnant Women Program Application (MC 263) and confidentially destroy any remaining forms.

For questions concerning enrollment, CBT and other PE4PW issues, providers may email PE@dhcs.ca.gov.