As Amended
SEC. 43-13-115.1. Presumptive eligibility for children under 19 years of age.
(1) There will be presumptive eligibility under this article for children under nineteen (19) years of age, in accordance with the following provisions:
(a) A child will be deemed to be presumptively eligible for covered benefits and services under this article if a qualified entity as defined under federal law (42 USCS Section 1396r-1a) determines, on the basis of preliminary information, that the family income of the child does not exceed the applicable income level of eligibility under the state Medicaid plan.
(b) A child will be presumptively eligible under this article from the date that the qualified entity determines that the child is presumptively eligible until the earlier of either: (i) The date on which a determination is made with respect to the eligibility of the child for covered benefits and services under this article, or
(ii) The last day of the month following the month in which presumptive eligibility is determined, if an application has not been filed on behalf of the child by that day.
(c) For the period during which a child is presumptively eligible under this article, the child will be eligible to receive all covered benefits and services under this article.
(d) If a child is determined to be presumptively eligible under this article, the child's parent, guardian or caretaker relative must submit a completed application for Medicaid assistance no later than the last day of the month following the month in which presumptive eligibility is determined. The qualified entity shall inform the parent, guardian or caretaker relative of this requirement at the time the qualified entity makes the determination of presumptive eligibility.
(e) The qualified entity shall notify the Division of Medicaid of the determination of presumptive eligibility within five (5) working days after the date on which the determination is made.
(f) The Division of Medicaid shall provide qualified entities with such forms as are necessary for an application to be made on behalf of a child for eligibility under this article. The Division of Medicaid shall make those application forms and the application process itself as simple as possible.
SOURCES: Laws, 2001, ch. 532, § 11, HB 444, eff from and after June 30, 2001.