HB177INTRODUCED
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HB177
X2A6Z7E-1
By Representatives Robbins, Underwood
RFD: Ways and Means General Fund
First Read: 05-Feb-25
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5 X2A6Z7E-1 02/04/2025 JC (L)lg 2024-2144
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First Read: 05-Feb-25
SYNOPSIS:
Under existing law, when a child who is approved
for Medicaid is also covered by a parent's private
health insurance, the private health insurance must pay
before Medicaid will pay.
This bill would require a custodial parent of a
child covered by Medicaid to put the child on the
health care insurance offered by an employer when
coverage for the child is also available. If a
noncustodial parent is under an order to pay child
support, the court may also order that the child be
included on the parent's employer-provided health care
insurance or order the parent to purchase coverage for
the child.
If a parent fails to include a child approved
for Medicaid on available health care coverage provided
by an employer or as otherwise ordered by a court, this
bill would authorize the Medicaid agency to recover any
health care payments made for the child by a civil suit
against the parent.
This bill would further provide that a parent
automatically authorizes any employer to release
information to the Medicaid agency when a parent's
child is approved by either program for coverage.
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A BILL
TO BE ENTITLED
AN ACT
Relating to Medicaid; to require that a child who is
approved for Medicaid receive health care coverage through a
parent's insurance in certain circumstances, or that a parent
under a child support order provide health care coverage; and
to further provide for the right to reimbursement for Medicaid
for benefits paid on behalf of a child who would be eligible
for coverage under a parent's employer-provided insurance.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For the purposes of this section, the
following terms have the following meanings:
(1) AGENCY. The Medicaid Agency of the State of Alabama
and any contractor of the agency.
(2) APPROVED CHILD. An individual who is under 19 years
of age and is approved for health coverage under Medicaid.
(3) CUSTODIAL PARENT. A natural or adoptive parent of
an approved child who shares the same household with the child
as reported on an application for health coverage approved by
the agency.
(4) EMPLOYER-PROVIDED HEALTH COVERAGE. Health coverage
that is made available by an employer to an employee.
(5) HEALTH COVERAGE. Any plan, policy, or contract
issued, delivered, or renewed in this state that provides
health coverage, including payment for hospital or physician
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health coverage, including payment for hospital or physician
care, treatment, therapy, drugs, equipment, or any other
medical expense, and which is offered as a benefit of
employment, regardless of whether the plan, policy, or
contract is provided by a health care insurer, health
maintenance organization operating pursuant to Chapter 21A of
Title 27, Code of Alabama 1975, health care service plan
operating pursuant to Article 6, Chapter 20 of Title 10A, Code
of Alabama 1975, or any other person that pays for, purchases,
or reimburses health care services.
(6) NONCUSTODIAL PARENT. A natural or adoptive parent
of an approved child who is subject to a court order to
provide child support.
(b) A custodial parent of an approved child shall elect
employer-provided health coverage of the child when it is
available to the parent and the terms of the employer-provided
health coverage so provide, unless the approved child is the
subject of a court order to provide health coverage.
(c) A court having jurisdiction over a noncustodial
parent, in its discretion, may order the parent to provide
health coverage to an approved child when the court determines
from the State of Alabama Unified Judicial System
Child-Support-Obligation Income Statement/Affidavit form, or
other evidence, that the parent is receiving income in an
amount sufficient to include the approved child under
available employer-provided health coverage or under health
coverage purchased through the federal Health Insurance
Marketplace.
(d)(1) A parent of an approved child shall report a
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(d)(1) A parent of an approved child shall report a
change in status to the agency, as appropriate, when one of
the following occurs:
a. Commencement of eligibility of the approved child
for employer-provided health coverage and the parent's
election of the coverage.
b. Discontinuation of coverage of the approved child
caused by a change in the terms of the employer-provided
health coverage.
c. Separation of the parent from employment for any
reason which results in a discontinuation of employer-provided
health coverage of the approved child.
d. Commencement or termination of a court-ordered
obligation that a noncustodial parent provide health coverage
for an approved child.
(2) Nothing in this section shall be construed to
require a custodial parent to continue health coverage for an
approved child under the federal Consolidated Omnibus Budget
Reconciliation Act when the parent is separated from
employment.
(3) Nothing in this section shall be construed to
disqualify an approved child from coverage under Medicaid when
a noncustodial parent fails to comply with a court order under
subsection (c).
(e) If an approved child has employer-provided health
coverage through a custodial parent, or health coverage
through a noncustodial parent under court order, the agency
shall administer claims made on behalf of the approved child
consistent with the status of Medicaid as payor of last resort
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consistent with the status of Medicaid as payor of last resort
under the respective rules, policies, and practices in force.
(f)(1) If Medicaid pays for hospital or physician care,
treatment, therapy, drugs, equipment, or any other medical
expense on behalf of an approved child who would be covered
under available employer-provided health coverage or under
other court-ordered health coverage that has not been elected
by a parent, the agency may pursue reimbursement from the
parent of the amounts paid as a collectible debt up to civil
suit in a court of competent jurisdiction in the county in
which the parent resides.
(2) In addition to any means provided by law for
recovery and satisfaction of a civil judgment, in a case in
which a judgment is entered in favor of the agency, monies
subject to garnishment shall include any amount owed by the
State of Alabama to the parent for overpayment of personal
income tax.
(3) In any civil action brought by the agency to
recover amounts paid, a parent may assert as a defense that
the available employer-provided health coverage or other
court-ordered health coverage would not have paid for the
specific hospital or physician care, treatment, therapy,
drugs, equipment, or any other medical expense that Medicaid
paid.
(g) In any case in which Medicaid pays for hospital or
physician care, treatment, therapy, drugs, equipment, or any
other medical expense on behalf of an approved child who is
the subject of a court order to provide health coverage with
which the noncustodial parent has failed to comply, upon
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which the noncustodial parent has failed to comply, upon
notice of a claim received from the federal Centers for
Medicare & Medicaid Services (CMS), CMS shall have a lien on
the amount recovered through enforcement by the agency of the
remedy provided in subdivision (f)(1).
(h) Any parent of an approved child, including a
noncustodial parent, is deemed to authorize any employer to
release to the agency all information necessary to enforce
this section.
(i) The agency and the Department of Revenue may adopt
rules necessary to implement and enforce this section.
Section 2. This act shall become effective on October
1, 2025.
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