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. This presumptive eligibility period lasts for up to 60 days and allows women to receive ambulatory prenatal care without retroactive denial of coverage due to application submission failures. The bill specifies that a woman can only receive one presumptive eligibility period per pregnancy and mandates that the agency adopt rules to define acceptable documentation for preliminary information.

Additionally, the bill includes a provision for the agency to notify the Medicaid agency of the presumptive eligibility determination within five working days and requires the woman to apply for Medicaid by the end of the month following the determination. The act is set to be repealed on October 1, 2028, and will take effect on October 1, 2025. The legal language that is inserted includes definitions for terms such as "qualified provider" and "presumptive eligibility period," while no deletions from current law are specified in the text provided.