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FL H1351

FL H1351
Presumptive Medicaid Eligibility for Pregnant Women


summary

Introduced
01/09/2026
In Committee
01/15/2026
Crossed Over
Passed
Dead

Introduced Session

2026 Regular Session

Bill Summary

An act relating to presumptive Medicaid eligibility for pregnant women; amending s. 409.903, F.S.; authorizing certain entities meeting specified criteria to serve as qualified Medicaid providers for purposes of making presumptive Medicaid eligibility determinations for pregnant women; requiring the Department of Children and Families to ensure that such providers are adequately trained and monitored for compliance when serving in such roles; requiring the Agency for Health Care Administration to provide Medicaid coverage to pregnant women deemed presumptively eligible for the duration of a specified time period; providing that pregnant women deemed presumptively eligible are entitled to coverage of all medically necessary services under the Medicaid program during such eligibility period; requiring that all prior authorizations granted before or during such period remain in effect for the duration of such period; requiring the agency, within a specified timeframe, to seek federal approval to extend the allowable period of presumptive Medicaid eligibility coverage for pregnant women; requiring the agency and the department to initiate certain rulemaking within a specified timeframe; providing an effective date.

AI Summary

This bill expands presumptive Medicaid eligibility for pregnant women, allowing certain qualified entities like hospitals, federally qualified health centers, birth centers, maternal and child health organizations, WIC clinics, and local housing authorities to make immediate eligibility determinations. The Department of Children and Families (DCF) will train and monitor these providers to ensure compliance. The Agency for Health Care Administration (AHCA) will provide Medicaid coverage to these presumptively eligible pregnant women for the maximum period allowed by federal law or until a final eligibility decision is made, ensuring they receive all medically necessary services, including those from specialists for high-risk pregnancies, and that any previously approved prior authorizations remain valid. AHCA is also required to seek federal approval to extend this presumptive eligibility period to 180 days and, along with DCF, initiate necessary rulemaking within 60 days of the bill becoming law, which takes effect on July 1, 2026.

Committee Categories

Health and Social Services

Sponsors (2)

Last Action

Now in Health Care Facilities & Systems Subcommittee (on 01/15/2026)

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