SB102ENGROSSED
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SB102
V8KJVVP-2
By Senators Coleman-Madison, Figures, Kelley, Beasley,
Smitherman, Albritton, Stutts
RFD: Children and Youth Health
First Read: 05-Feb-25
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First Read: 05-Feb-25
A BILL
TO BE ENTITLED
AN ACT
Relating to Medicaid; to provide presumptive
eligibility to pregnant women for Medicaid prior to the
Medicaid agency's approval of an application for Medicaid
coverage; to limit the eligibility to what is provided under
the state Medicaid plan for a period not exceeding 60 days; to
authorize the agency to adopt rules to implement this
provision; and to provide for the repeal of this act.
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.
(2) PRELIMINARY INFORMATION. Proof of pregnancy and
documentation attesting to monthly household income.
(3) PRESUMPTIVE ELIGIBILITY PERIOD. The period that
starts on the date on which a qualified provider determines on
the basis of preliminary information that a woman is eligible
for Medicaid coverage for pregnant women and which ends on and
includes the earliest of the following dates:
a. On which the agency makes a determination of
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a. On which the agency makes a determination of
eligibility for coverage based upon an application filed by
the woman.
b. If the woman fails to file an application with the
agency for coverage, the last day of the month following the
month in which the qualified provider made the determination
of presumptive eligibility.
c. No later than the sixtieth day after the qualified
provider made the determination of presumptive eligibility.
(4) QUALIFIED PROVIDER. Any provider of ambulatory
prenatal care as defined in 42 U.S.C. ยง 1396r-1 which is
qualified by the agency.
(b)(1) A pregnant woman shall be presumptively eligible
for coverage for ambulatory prenatal care under Medicaid if a
qualified provider determines on the basis of preliminary
information that her household income does not exceed the
modified adjusted gross income limit for the eligibility of
pregnant women which is in effect under the state Medicaid
plan.
(2) A pregnant woman who is determined to be
presumptively eligible may receive no more than one
presumptive eligibility period per pregnancy.
(3) Coverage provided by the agency for the presumptive
eligibility period may not be retroactively denied due to
failure of the woman to submit an application for Medicaid or
the agency's negative decision on the application.
(c) A qualified provider that determines that a woman
is presumptively eligible for ambulatory prenatal care, at the
time of making the determination, shall: (i) notify the agency
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time of making the determination, shall: (i) notify the agency
of the determination within five working days; and (ii) inform
the woman that she must apply to the agency for Medicaid no
later than the last day of the following month.
(d) A woman who is determined to be presumptively
eligible for ambulatory prenatal care shall apply to the
agency for Medicaid no later than the last day of the month
following the month in which the determination is made.
(e)(1) The agency shall adopt rules that define the
acceptable documentation of preliminary information, which may
not exceed proof of pregnancy and a facial proof of current
household income.
(2) The agency may develop a worksheet and any other
necessary forms for use by a qualified provider to determine
preliminary eligibility.
(f) This section is repealed on October 1, 2028.
Section 2. This act shall become effective on October
1, 2025.
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1, 2025.
Senate
Read for the first time and referred
to the Senate committee on Children
and Youth Health
................05-Feb-25
Read for the second time and placed
on the calendar:
0 amendments
................12-Feb-25
Read for the third time and passed
as amended
Yeas 31
Nays 0
Abstains 0
................20-Feb-25
Patrick Harris,
Secretary.
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