Section 210-RICR-30-00-4.2 - Scope and Purpose of Hospital Presumptive Eligibility Program for MedicaidA. The State of Rhode Island had determined that presumptive eligibility will be available to individuals in the MACC groups who qualify for Medicaid-funded affordable coverage. For all other individuals with MACC-like characteristics, presumptive eligibility must be determined by a qualified hospital, licensed in Rhode Island, and is only available in certain circumstances contingent upon preliminary information supplied by the individual. Further, presumptive eligibility is only available on a temporary basis - until the last day of the month following the initial determination of presumptive eligibility or the date full eligibility is determined, whichever comes first. 1. Exclusions: Individuals in the MACC groups who are eligible for affordable coverage funded through the Children's Health Insurance Program (CHIP) under Title XXI of the U.S. Social Security Act are excluded from presumptive eligibility. CHIP-funded beneficiaries excluded from HPE are as follows: a. All lawfully present non-citizen children while subject to the federal five (5) year ban;b. Children up to age 19 with income from 133% to 261% of the FPL;c. All non-qualified non-citizen pregnant women with income up to 253% of the FPL; andd. Pregnant women with income from 185% to 253% of the FPL.2. Implementation - Effective January 27, 2014, the State will be making presumptive eligibility available to individuals who have been determined by a qualified hospital to meet the characteristics of one of the MACC groups identified in "Medicaid Code of Administrative Rules, Section 1301, 'Medicaid Affordable Care Coverage Groups'" (and as below) eligible for Medicaid-funded affordable coverage under Title XIX, with the exception of the exclusions noted above.3. Governing Provisions - The purpose of these rules is to set forth the provisions governing hospital presumptive eligibility determinations including, but are not limited to the: a. Qualifications of applicants for Medicaid presumptive eligibility;b. Criteria that a qualified hospital must use when making a determination of presumptive eligibility;c. Application timelines and procedures for individuals who qualify for Medicaid coverage during the presumptive eligibility period.210 R.I. Code R. 210-RICR-30-00-4.2