Healthy Beginnings Plus Program. The CHC-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 CHC-MCO must provide a full description of its plan to provide prenatal care and comprehensive postpartum care for pregnant women in fulfillment of the HBP Program objectives to the Department for review and advance written approval. The CHC-MCO must also continue the coordinated prenatal activities of the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. The CHC-MCO must submit any such comparable programs to the Department for review and approval. The CHC-MCO’s prenatal program must have the majority of its pregnant Participants seen face-to-face in a community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported. This will be accomplished by relationships within the CHC-MCO’s Network, CHC-MCO employees, or delegated vendor relationship. The CHC-MCO program must provide for the adequate treatment of high risk pregnant women with SUD. The CHC-MCO will contract with high volume obstetrical hospitals and health systems that perform more than 900 MA deliveries to establish highly coordinated health homes for pregnant Participants with SUD. These health homes will be focused on identifying, initiating treatment, and referring pregnant Participants for comprehensive drug and alcohol counseling services. If the CHC-MCO is unsuccessful in contracting with any of the high volume obstetrical hospitals or health systems, it must document its efforts to negotiate with these providers for review by the Department.
Healthy Beginnings Plus Program. The CHC-MCO must provide services that meet or exceed HBP standards in effect as defined in 55 Pa. Code Chapter 1140 (relating to Healthy Beginnings Plus Program) and current or future guidance provided in MA Bulletins. The CHC- MCO must also continue the coordinated services relating to pregnancy included in the HBP Program by utilizing enrolled HBP Providers or developing comparable resources. The CHC-MCO must submit any such comparable programs to the Department for review and approval. The CHC-MCO’s prenatal program must have the majority of its pregnant Participants seen face-to-face in a community setting. Majority is defined as greater than fifty percent (50%) of unique pregnant women that have an initial care management assessment as reported. This will be accomplished by relationships within the CHC-MCO’s Network, CHC-MCO employees, or delegated vendor relationship. The HBP Program requires that pregnant women be adequately screened for substance use disorders and referred to treatment for positive screenings.
