MedicaidCoverageMedium impact
Hospital Presumptive Eligibility Program Update
Medi-Cal·CA·Provider Bulletin
Effective date
May 28, 2026
We identified it
May 24, 2026
Summary
Effective May 28, 2026, California's Hospital Presumptive Eligibility (HPE) program will no longer cover patients 65 and older, and adults aged 19-64 with Medicare Part A/B will be ineligible for the New Adult coverage group. Providers must use the updated HPE application form and cannot use previous versions.
Action Required
By May 28, 2026: Hospital billing teams must obtain and implement the revised Hospital Presumptive Eligibility Medi-Cal Application (DHCS 7022) from the HPE web page and discontinue use of previous versions. Update Provider Portal workflows to screen for Medicare Part A/B coverage for adults aged 19-64 in New Adult group - these patients will be automatically denied HPE. Train staff that patients 65+ are no longer eligible for HPE and must apply for full Medi-Cal instead.