This text of Alabama § 22-6-10.1 ((Repealed by Act 2025-204, § 1(F), Effective October 1, 2028) Presumptive Eligibility for Pregnant Women) is published on Counsel Stack Legal Research, covering Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.
(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 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 pr
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(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 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. § 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 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 facile 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.