Alabama 2025 Regular Session

Alabama Senate Bill SB102 Compare Versions

Version 1 (Old)

Version 2 (New)

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1		-	~~SB102ENGROSSED~~
	1	+	SB102INTRODUCED
2	2		Page 0
3	3		SB102
4		-	V8KJVVP-2
	4	+	V8KJVVP-1
5	5		By Senators Coleman-Madison, Figures, Kelley, Beasley,
6	6		Smitherman, Albritton, Stutts
7	7		RFD: Children and Youth Health
8	8		First Read: 05-Feb-25
9	9		1
10	10		2
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12	12		4
13	13		5
14		-	6 ~~SB102 Engrossed~~
	14	+	6 V8KJVVP-1 02/04/2025 JC (L)lg 2025-563
15	15		Page 1
16	16		First Read: 05-Feb-25
	17	+	SYNOPSIS:
	18	+	Federal law provides that a state Medicaid plan
	19	+	may pay for prenatal care for a pregnant woman for a
	20	+	period of no more than 60 days during the pregnancy
	21	+	while a decision is pending on the pregnant woman's
	22	+	application for Medicaid coverage.
	23	+	This bill would adopt this provision by
	24	+	extending the existing pregnant women benefit under the
	25	+	state Medicaid plan for up to 60 days to women who have
	26	+	not been formally approved for Medicaid coverage but
	27	+	who submit proof of pregnancy and household income
	28	+	information to a qualified provider of ambulatory
	29	+	prenatal care.
17	30		A BILL
18	31		TO BE ENTITLED
19	32		AN ACT
20	33		Relating to Medicaid; to provide presumptive
21	34		eligibility to pregnant women for Medicaid prior to the
22	35		Medicaid agency's approval of an application for Medicaid
23	36		coverage; to limit the eligibility to what is provided under
24		-	the state Medicaid plan for a period not exceeding 60 days; to
25		-	authorize the agency to adopt rules to implement this
26		-	provision; and to provide for the repeal of this act.
27		-	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
28		-	Section 1. (a) For the purposes of this section, the
29		-	following terms have the following meanings:
30		-	(1) AGENCY. The Medicaid Agency of the State of
31		-	Alabama.
32		-	(2) PRELIMINARY INFORMATION. Proof of pregnancy and
33		-	documentation attesting to monthly household income.
34		-	(3) PRESUMPTIVE ELIGIBILITY PERIOD. The period that
35		-	starts on the date on which a qualified provider determines on
36		-	the basis of preliminary information that a woman is eligible
37		-	for Medicaid coverage for pregnant women and which ends on and
38		-	includes the earliest of the following dates:
39		-	a. On which the agency makes a determination of
	37	+	the state Medicaid plan for a period not exceeding 60 days;
	38	+	and to authorize the agency to adopt rules to implement this
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67		-	28 SB102 ~~Engrossed~~
	66	+	28 SB102 INTRODUCED
68	67		Page 2
	68	+	and to authorize the agency to adopt rules to implement this
	69	+	provision.
	70	+	BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
	71	+	Section 1. (a) For the purposes of this section, the
	72	+	following terms have the following meanings:
	73	+	(1) AGENCY. The Medicaid Agency of the State of
	74	+	Alabama.
	75	+	(2) PRELIMINARY INFORMATION. Proof of pregnancy and
	76	+	documentation attesting to monthly household income.
	77	+	(3) PRESUMPTIVE ELIGIBILITY PERIOD. The period that
	78	+	starts on the date on which a qualified provider determines on
	79	+	the basis of preliminary information that a woman is eligible
	80	+	for Medicaid coverage for pregnant women and which ends on and
	81	+	includes the earliest of the following dates:
69	82		a. On which the agency makes a determination of
70	83		eligibility for coverage based upon an application filed by
71	84		the woman.
72	85		b. If the woman fails to file an application with the
73	86		agency for coverage, the last day of the month following the
74	87		month in which the qualified provider made the determination
75	88		of presumptive eligibility.
76	89		c. No later than the sixtieth day after the qualified
77	90		provider made the determination of presumptive eligibility.
78	91		(4) QUALIFIED PROVIDER. Any provider of ambulatory
79	92		prenatal care as defined in 42 U.S.C. § 1396r-1 which is
80	93		qualified by the agency.
81	94		(b)(1) A pregnant woman shall be presumptively eligible
82	95		for coverage for ambulatory prenatal care under Medicaid if a
83	96		qualified provider determines on the basis of preliminary
84		-	information that her household income does not exceed the
85		-	modified adjusted gross income limit for the eligibility of
86		-	pregnant women which is in effect under the state Medicaid
87		-	plan.
88		-	(2) A pregnant woman who is determined to be
89		-	presumptively eligible may receive no more than one
90		-	presumptive eligibility period per pregnancy.
91		-	(3) Coverage provided by the agency for the presumptive
92		-	eligibility period may not be retroactively denied due to
93		-	failure of the woman to submit an application for Medicaid or
94		-	the agency's negative decision on the application.
95		-	(c) A qualified provider that determines that a woman
96		-	is presumptively eligible for ambulatory prenatal care, at the
97		-	time of making the determination, shall: (i) notify the agency
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125		-	56 SB102 ~~Engrossed~~
	124	+	56 SB102 INTRODUCED
126	125		Page 3
	126	+	qualified provider determines on the basis of preliminary
	127	+	information that her household income does not exceed the
	128	+	modified adjusted gross income limit for the eligibility of
	129	+	pregnant women which is in effect under the state Medicaid
	130	+	plan.
	131	+	(2) A pregnant woman who is determined to be
	132	+	presumptively eligible may receive no more than one
	133	+	presumptive eligibility period per pregnancy.
	134	+	(3) Coverage provided by the agency for the presumptive
	135	+	eligibility period may not be retroactively denied due to
	136	+	failure of the woman to submit an application for Medicaid or
	137	+	the agency's negative decision on the application.
	138	+	(c) A qualified provider that determines that a woman
	139	+	is presumptively eligible for ambulatory prenatal care, at the
127	140		time of making the determination, shall: (i) notify the agency
128	141		of the determination within five working days; and (ii) inform
129	142		the woman that she must apply to the agency for Medicaid no
130	143		later than the last day of the following month.
131	144		(d) A woman who is determined to be presumptively
132	145		eligible for ambulatory prenatal care shall apply to the
133	146		agency for Medicaid no later than the last day of the month
134	147		following the month in which the determination is made.
135	148		(e)(1) The agency shall adopt rules that define the
136	149		acceptable documentation of preliminary information, which may
137	150		not exceed proof of pregnancy and a facial proof of current
138	151		household income.
139	152		(2) The agency may develop a worksheet and any other
140	153		necessary forms for use by a qualified provider to determine
141	154		preliminary eligibility.
142		-	(f) This section is repealed on October 1, 2028.
143		-	Section 2. This act shall become effective on October
144		-	1, 2025.
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161		-	73 SB102 Engrossed
162		-	Page 4
163		-	1, 2025.
164		-	Senate
165		-	Read for the first time and referred
166		-	to the Senate committee on Children
167		-	and Youth Health
168		-	................05-Feb-25
169		-	Read for the second time and placed
170		-	on the calendar:
171		-	0 amendments
172		-	................12-Feb-25
173		-	Read for the third time and passed
174		-	as amended
175		-	Yeas 31
176		-	Nays 0
177		-	Abstains 0
178		-	................20-Feb-25
179		-	Patrick Harris,
180		-	Secretary.
	171	+	73
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	182	+	84 SB102 INTRODUCED
	183	+	Page 4
	184	+	preliminary eligibility.
	185	+	Section 2. This act shall become effective on October
	186	+	1, 2025.
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