Newborns. 4.2.6.1 When a child is born to a mother enrolled in Turquoise Care, the hospital or other Provider shall notify the HCA of the child’s birth. Hospitals or other Providers shall notify HCA by either using the electronic process available through the Baby Bot program (or its successor) or by completing a Notification of Birth, MAD Form 313 (or its successor) prior to or at the time of discharge. Upon receipt of the notification of the child’s birth, HCA shall ensure that the eligibility process is immediately commenced and that upon completion of the eligibility process the newborn is enrolled into their mother’s MCO. 4.2.6.2 Medicaid eligible newborns are eligible for a period of thirteen (13) months, starting with the month of birth. The newborn shall be enrolled retroactively to the month of birth with the mother’s MCO. 4.2.6.3 When a Medicaid-eligible child is born to a mother on the New Mexico Health Insurance Exchange and the mother’s Qualified Health Plan is also a Turquoise Care MCO, the newborn shall be enrolled retroactively to the month of birth with that Turquoise Care MCO. 4.2.6.4 When a Medicaid-eligible child is born to a mother on the New Mexico Health Insurance Exchange and the mother’s Qualified Health Plan is not a Turquoise Care MCO, the newborn shall be auto-assigned and enrolled in a Turquoise Care MCO (in accordance with Section 4.2.5 of this Agreement) retroactively to the month of birth. The mother shall have one (1) opportunity anytime during the three (3) months from the effective date of enrollment to change the newborn’s MCO assignment. 4.2.6.5 Newborns are not considered part of the retroactive reconciliation period if the mother of the newborn is enrolled in Turquoise Care at the time of delivery.
Appears in 9 contracts
Samples: Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement, Medicaid Managed Care Services Agreement
