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Bill > H1003


FL H1003

Medicaid Presumptive Eligibility For Pregnant Women


summary

Introduced
02/25/2025
In Committee
03/02/2025
Crossed Over
Passed
Dead

Introduced Session

2025 Regular Session

Bill Summary

An act relating to Medicaid presumptive eligibility for pregnant women; creating s. 409.9026, F.S.; creating a pilot program to provide temporary Medicaid coverage to pregnant women who are presumptively eligible for Medicaid; defining terms; authorizing the Agency for Health Care Administration to approve certain entities to serve as qualified presumptive eligibility locations under the pilot program; providing application requirements; requiring the agency to prioritize the approval of qualified entities located in underserved areas of this state; specifying duties of qualified entities; requiring qualified entities to provide written notice of their determinations to applicants within a specified timeframe; providing requirements for the notice; specifying performance standards qualified entities are required to meet each year to continue participating in the pilot program; specifying the timeframe of the presumptive eligibility period for temporary Medicaid coverage under the pilot program; requiring the agency to implement certain procedures that allow for the seamless transition from temporary Medicaid coverage under the pilot program to enrollment for full Medicaid benefits; requiring the agency, in collaboration with the Department of Health, to implement an outreach program for specified purposes; requiring the agency, by a specified date, to seek federal approval to implement the pilot program; requiring the agency to implement the pilot program within a specified timeframe after receiving such federal approval; providing an effective date.

AI Summary

This bill establishes a 10-year pilot program to expand Medicaid presumptive eligibility for pregnant women in Florida, focusing on increasing access to prenatal care in underserved areas. The program allows various healthcare entities like community health centers, county health departments, and nonprofit organizations to become "qualified entities" that can make preliminary Medicaid eligibility determinations for pregnant women. Under this pilot program, qualified entities can provide temporary Medicaid coverage to women who are likely to meet eligibility requirements, with the coverage lasting up to 180 days or until a full Medicaid application is processed. These entities must meet specific performance standards, such as ensuring 90% of presumptively eligible individuals submit full Medicaid applications and are ultimately approved. The bill requires the Agency for Health Care Administration to seek federal approval by October 1, 2025, and implement procedures to help women seamlessly transition from temporary to full Medicaid coverage. Additionally, the agency will collaborate with the Department of Health to conduct community outreach and encourage participation in the program. The goal is to provide quick, temporary healthcare coverage to pregnant women while they complete the full Medicaid application process, particularly in areas with limited healthcare access.

Committee Categories

Health and Social Services

Sponsors (2)

Last Action

Indefinitely postponed and withdrawn from consideration (on 05/03/2025)

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