AL HB89

Pregnant women become presumptively eligible for Medicaid ambulatory prenatal care upon a qualified provider's determination that household income does not exceed the modified adjusted gross income limit under the state Medicaid plan.

Presumptive eligibility period begins on the date a qualified provider makes the determination and ends on the earliest of: the date the agency makes an eligibility determination, the last day of the month following the determination if the woman fails to apply, or 60 days after the determination.

Qualified providers must notify the Medicaid Agency within five working days of determining presumptive eligibility and inform the woman she must apply for Medicaid coverage by the last day of the following month.

Coverage during the presumptive eligibility period cannot be retroactively denied due to the woman's failure to submit an application or the agency's negative decision on the application; each woman may receive only one presumptive eligibility period per pregnancy.

The Medicaid Agency shall adopt rules defining acceptable documentation of preliminary information limited to proof of pregnancy and current household income; the entire provision repeals on October 1, 2028; the act becomes effective on October 1, 2025.