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

Standard XV: Immunizations, Pregnancy, Drugs & Transportation
CONTRACT
SECTION
CC-V.H.15.l.1-2
18. Pregnancyrelated
Requirements:
Newborn Care
AGENCY FOR HEALTHCARE ADMINISTRATION
MANAGED CARE ORGANIZATIONS
Compliance Monitoring Tool with Specific Contract Standards
CONTRACT REQUIREMENT COMPLIANT SCORING
• The health plan ensures that all providers
document preterm delivery risk assessments
in the enrollee’s medical record by week
twenty-eight (28).
• If the provider determines that the enrollee’s
pregnancy is high risk, the health plan ensures
that the provider’s obstetrical care during
labor and delivery includes preparation by all
attendants for symptomatic evaluation and
that the enrollee progresses through the final
stages of labor and immediate postpartum
care.
The health plan makes certain that its providers supply
the highest level of care for the newborn beginning
immediately after birth. Such level of care includes,
but is not limited to, the following:
• Instilling of prophylactic eye medications into
each eye of the newborn.
• When the mother is Rh negative, securing a
cord blood sample for type Rh determination
and direct Coombs test.
• Weighing and measuring of the newborn.
• Inspecting the newborn for abnormalities
and/or complications.
• Administering one half (.5) milligram of
vitamin K.
• APGAR scoring.
• Any other necessary and immediate need for
referral in consultation from a specialty
DOCUMENTS
REVIEWED
FINDINGS
State of Florida Compliance Monitoring_Standard_XV_F2_07_11
Yes
No
Met
Partially Met
Not Met
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