Letter to CMS - Medicaid Managed Care Policies - Agency for ...

Standard XV: Immunizations, Pregnancy, Drugs & Transportation
CONTRACT
SECTION
Chapter 381, F.S.
s. 384.31, F.S.
64D-3.019, F.A.C.
CC-V.H.15.e.1-3
12. Pregnancyrelated
Requirements:
Hepatitis B
Screenings
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
all pregnant women counseling and HIV
testing at the initial prenatal care visit and
again at twenty-eight (28) and thirty-two (32)
weeks.
• The health plan ensures that its providers
attempt to obtain a signed objection if a
pregnant woman declines an HIV test.
• The health plan ensures that all pregnant
women who are infected with HIV are
counseled about and offered the latest
antiretroviral regimen recommended by the
U.S. Department of Health & Human Services
(Public Health Service Task Force Report
entitled Recommendations for the Use of
Antiretroviral Drugs in Pregnant HIV-1
Infected Women for Maternal Health and
Interventions to Reduce Perinatal HIV-1
Transmission in the United States).
The health plan ensures that its providers screen all
pregnant enrollees receiving prenatal care for the
Hepatitis B surface antigen (HBsAg) during the first
prenatal visit.
• The health plan ensures that the providers
perform a second HBsAg test between
twenty-eight (28) and thirty-two (32) weeks
of pregnancy for all pregnant enrollees who
tested negative at the first prenatal visit and
are considered high-risk for Hepatitis B
infection. This test is performed at the same
time that other routine prenatal screenings are
ordered.
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XV_F2_07_11
Yes
No
Met
Partially Met
Not Met
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