The bill aims to provide presumptive eligibility for Medicaid coverage to pregnant women prior to the formal approval of their applications by the Medicaid agency. Under the new provisions, a qualified provider can determine a woman's eligibility based on preliminary information, which includes proof of pregnancy and documentation of household income. The presumptive eligibility period will last for up to 60 days, during which the woman can receive ambulatory prenatal care. The bill specifies that a woman can only receive one presumptive eligibility period per pregnancy and that coverage cannot be retroactively denied due to the failure to submit an application or a negative decision on the application.

To implement this provision, the Medicaid agency is authorized to adopt rules defining acceptable documentation for preliminary information, which will not exceed proof of pregnancy and current household income. Additionally, the agency must be notified of the presumptive eligibility determination within five working days. The bill includes a repeal clause, stating that this section will be repealed on October 1, 2028, and it will take effect on October 1, 2025. The legal language that is inserted includes definitions of terms such as "qualified provider" and "presumptive eligibility period," while no deletions from current law are specified in the text provided.