Md. Code Regs. 10.67.04.08

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.04.08 - Special Needs Populations - Pregnant and Postpartum Women

A. An MCO shall meet the standards set forth in this regulation for treating pregnant and postpartum women.

B. An MCO shall ensure access to prenatal care for pregnant women and postpartum care for postpartum women by:

(1) Scheduling an appointment for the first prenatal visit and seeing the woman within 10 days of request;

(2) Scheduling an appointment for a postpartum woman and seeing the woman within 10 days of request:

(3) Arranging for an adequate network of providers including obstetricians, gynecologists, perinatologists, neonatologists, anesthesiologists, and advanced practice nurses who are capable of addressing complex maternal and infant health issues; and

(4) Linking a pregnant woman with a pediatric provider before delivery.

C. An MCO shall ensure that prenatal providers:

(1) Complete a prenatal risk assessment, using an instrument approved by the Department, at the first prenatal visit; and

(2) Within 10 days of completing the prenatal risk assessment, forward this instrument to the local health department in the jurisdiction in which the pregnant enrollee lives.

D. The Department may not include questions about a woman's HIV infection status on the prenatal risk assessment instrument.

E. An MCO shall refer pregnant and postpartum women with a substance use disorder to the behavioral health ASO for substance use treatment within 24 hours of request.

F. An MCO shall refer pregnant and postpartum women, infants, and children younger than 5 years old to the WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) Program, and shall provide to WIC necessary medical information to determine WIC nutritional eligibility.

G. An MCO shall follow, at a minimum, the American College of Obstetricians and Gynecologists (ACOG) guidelines for pregnant and postpartum women.

H. An MCO shall provide risk-related medical and nonmedical preventive treatment services, including nutrition counseling by licensed nutritionists or dietitians and smoking cessation education and treatment for pregnant and postpartum women.

I. An MCO shall provide HIV counseling, including a risk assessment and information about possible transmission of HIV to the fetus.

J. An MCO shall offer its pregnant and postpartum enrollees voluntary HIV counseling and testing following the requirements of COMAR 10.67.67.

K. An MCO shall arrange for the appropriate emergency transfer of pregnant women, newborns, and infants to tertiary care centers.

Md. Code Regs. 10.67.04.08

Regulations .08 recodified from 10.09.65.08 effective 46:22 Md. R. 976, eff. 11/1/2019