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

Standard XV: Immunizations, Pregnancy, Drugs & Transportation
CONTRACT
SECTION
CC-V.H.15.f.1-2
13. Pregnancyrelated
Requirements:
HBIG and
HepB Vaccines
CC-V.H.15.g.1-3
14. Pregnancyrelated
Requirements:
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
• All HBsAg-positive women are to be reported
to the local CHD and to Healthy Start,
regardless of their Healthy Start screening
score.
The health plan ensures that infants born to HBsAgpositive
enrollees receive Hepatitis B Immune
Globulin (HBIG) and the Hepatitis B vaccine once
they are physiologically stable, preferably within
twelve (12) hours of birth, and completes the Hepatitis
B vaccine series according to the vaccine schedule
established by the Recommended Childhood
Immunization Schedule for the United States.
• The health plan ensures that its providers test
infants born to HBsAg-positive enrollees for
HBsAg and Hepatitis B surface antibodies
(anti-HBs) six (6) months after the completion
of the vaccine series to monitor the success or
failure of the therapy.
• The health plan ensures that providers report
to the local CHD a positive HBsAg result in
any child age 24 months or less within
twenty-four (24) hours of receipt of the
positive test results.
• The health plan ensures that infants born to
enrollees who are HBsAg-positive are
referred to Healthy Start regardless of their
Healthy Start screening score.
The health plan reports to the Perinatal Hepatitis B
Prevention Coordinator at the local CHD all prenatal
or postpartum enrollees who test HBsAg-positive. The
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XV_F2_07_11
Yes
No
Yes
No
Met
Partially Met
Not Met
Met
Partially Met
Not Met
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