Common use of Healthy Beginnings Plus (HBP Clause in Contracts

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard report. This will be accomplished by contractual relationships within the PH-MCO’s Provider Network, MCO employees, or delegated vendor relationship. The HBP Program also requires that high risk pregnant women should be adequately treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard report. This will be accomplished by contractual relationships within the PH-MCO’s Provider Network, MCO employees, or delegated vendor relationship. The HBP Program Programs also requires require that high risk pregnant women should be adequately treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard report. This will be accomplished by contractual relationships within the PH-MCO’s Provider Network, MCO employees, or delegated vendor relationship. The HBP Program also requires that high risk pregnant women should be adequately referred and treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members women with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members women for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- PH­ MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- face-to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard report. This will be accomplished by contractual relationships within the PH-PH­ MCO’s Provider Network, MCO employees, or delegated vendor relationship. The HBP Program also requires that high risk pregnant women should be adequately treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- face-to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard Comprehensive Care Management report. This will be accomplished by contractual relationships within the PH-MCO’s Provider Network, PH-MCO employees, or delegated vendor relationship. The HBP Program also requires that high risk pregnant women should be adequately treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.

Healthy Beginnings Plus (HBP. Program The PH-MCO must provide services that meet or exceed HBP standards in effect as defined in current or future MA Bulletins that govern the HBP Program. The PH-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department. The PH- MCO must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. Since the HBP program focuses on community based services provided by licensed and non-licensed providers who see recipients face-to-face in outpatient provider offices or community settings, the PH-MCO’s prenatal program must have the majority of its pregnant Members seen face- face-to-face in the community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported in Section II of the Operations 15 dashboard report. This will be accomplished by contractual relationships within the PH-PH- MCO’s Provider Network, MCO employees, or delegated vendor relationship. The HBP Program also requires that high risk pregnant women should be adequately treated for substance use disorder (SUD). The PH-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 Medicaid deliveries to establish highly coordinated health homes for pregnant Members with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Members for comprehensive drug and alcohol counseling services. If the PH-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with the provider for review by the Department.