North Carolina Contract Attachment Elements Sample Clauses

North Carolina Contract Attachment Elements. The following provisions include requirements of the North Carolina Contract and NCDHHS’s Advanced Medical Home Program Policy, Pregnancy Management Program Policy, Care Management for High-Risk Pregnancy Policy, and Care Management for At-Risk Children Policy. a. If Provider renders perinatal care, Provider agrees to comply with Department’s Pregnancy Management Program: i. Complete the standardized risk-screening tool at each initial visit; ii. Allow Health Plan or Health Plan’s designated vendor access to medical records for auditing purposes to measure performance on specific quality indicators; iii. Commit to maintaining or lowering the rate of elective deliveries prior to 39 weeks gestation; iv. Commit to decreasing the cesarean section rate among nulliparous women; v. Offer and provide 17 alpha-hydroxyprogesterone caproate (17p) for the prevention of preterm birth to women with a history of spontaneous preterm birth who are currently pregnant with a xxxxxxxxx gestation; vi. Complete a high-risk screening on each pregnant Medicaid Managed Care Member in the program and integrate the plan of care with local pregnancy care management; vii. Decrease the primary cesarean delivery rate if the rate is over the Department’s designated cesarean rate; and viii. Ensure comprehensive post-partum visits occur within 56 days of delivery. b. If Provider is an obstetrician, Provider agrees to comply with Department’s Pregnancy Management Program as described above. c. If Provider is an Advanced Medical Home, Provider agrees to comply with Department’s Advanced Medical Home Program: i. Accept Members and be listed as a primary care provider in Health Plan’s Member- facing materials for the purpose of providing care to Members and managing their health care needs. ii. Provide Primary Care and patient care coordination services to each Member, in accordance with Provider Manual. iii. Provide or arrange for primary care coverage for services, consultation or referral, and treatment for emergency medical conditions, 24 hours per day, 7 days per week. Automatic referral to the hospital emergency department for services does not satisfy this requirement. iv. Provide direct patient care a minimum of 30 office hours per week. v. Provide preventive services as required in the North Carolina Contract. vi. Maintain a unified patient medical record for each Member following the Health Plan’s medical record documentation guidelines. vii. Promptly arrange referrals for medically ...