Bill > HB2102

This bill directs the Department of Medical Assistance Services (DMAS) to seek federal authorization to implement presumptive eligibility for pregnant individuals, expanding upon existing hospital presumptive eligibility programs. If federal approval is granted, DMAS may authorize qualified entities like healthcare providers and community organizations to make preliminary eligibility determinations for pregnant women who meet specific Medicaid or FAMIS (Family Access to Medical Insurance Security) program criteria and have not already used a presumptive eligibility period during their current pregnancy. These qualified entities must provide applicants with medical assistance applications on the same day as the eligibility determination and offer assistance in completing those applications, including support from the Medicaid pregnancy unit. To maintain their qualified entity status, these organizations must adhere to federal and departmental regulations, including quality assurance metrics, training, and record-keeping requirements. Additionally, they must submit at least 90% of presumptive eligibility applications within 30 days, and the Department must approve at least 95% of submitted applications in a designated time period, with denials only permitted based on specific eligibility criteria.

Budget and Finance, Health and Social Services

https://lis.virginia.gov/bill-details/20251/HB2102