10 Colo. Code Regs. § 2505-3-170
Current through Register Vol. 47, No. 18, September 25, 2024
Section 10 CCR 2505-3-170 - PRESUMPTIVE ELIGIBILITY170.1 A pregnant applicant or a child under the age of 19 may apply for presumptive eligibility for immediate temporary medical services through designated presumptive eligibility sites. A. To qualify for presumptive eligibility, a child under the age of 19 shall have a declared household income that shall be greater than 142% but not exceed 260% of Federal Poverty Level ; orB. To qualify for presumptive eligibility, a pregnant women shall have an attested pregnancy, declare that her household's income shall be greater than 195% but not exceed 260% of the Federal Poverty Level ; andC. He/she shall be a United States citizen or a documented immigrant as defined in Section 110.170.2 Presumptive eligibility sites shall be certified by the Department of Health Care Policy and Financing to make presumptive eligibility determinations. Sites shall be re-certified by the Department of Health Care Policy and Financing every 2 years to remain approved presumptive eligibility sites. A. The presumptive eligibility site shall forward the application to the county within five business days of the received date.170.3 The presumptive eligibility period begins on the date the applicant(s) is determined eligible and ends with the day an eligibility determination for Medical Assistance is made for the applicant(s).170.4 The county or Medical Assistance site shall make an eligibility determination within 45 days from the date of application.A. Presumptively eligible clients may appeal the county or Medical Assistance site's failure to act on an application within 45 days from date of application or the denial of an application. Appeal procedures are outlined in Section 600.B. A presumptively eligible client may not appeal the end of a presumptive eligibility period.38 CR 11, June 10, 2015, effective 7/1/201540 CR 03, February 10, 2017, effective 3/2/201740 CR 17, September 10, 2017, effective 9/30/201740 CR 19, October 10, 2017, effective 10/30/201741 CR 19, October 10, 2018, effective 10/30/201842 CR 18, October 10, 2019, effective 10/1/201942 CR 23, December 10, 2019, effective 12/30/201943 CR 11, June 10, 2020, effective 5/8/202043 CR 17, September 10, 2020, effective 9/4/202044 CR 01, January 10, 2021, effective 12/11/202044 CR 17, September 10, 2021, effective 8/9/202144 CR 23, December 10, 2021, effective 11/12/202145 CR 03, February 10, 2022, effective 3/10/202245 CR 07, April 10, 2022, effective 3/11/202245 CR 11, June 10, 2022, effective 6/30/202245 CR 15, August 10, 2022, effective 7/8/202245 CR 22, November 25, 2022, effective 10/14/202245 CR 19, October 10, 2022, effective 10/30/202246 CR 06, March 25, 2023, effective 2/10/202346 CR 07, April 10, 2023, effective 4/30/202346 CR 11, June 10, 2023, effective 5/12/202346 CR 19, October 10, 2023, effective 10/30/2023