Common use of Transition of Care Requirements for Pregnant Women Clause in Contracts

Transition of Care Requirements for Pregnant Women. 4.4.16.3.1 In the event a Member entering the CONTRACTOR’s MCO is in her second or third trimester of pregnancy and is receiving medically necessary covered prenatal care services prior to enrollment in the CONTRACTOR’s MCO, the CONTRACTOR shall be responsible for providing continued access to the prenatal care Provider (whether Contract or Non-Contract Provider) through the postpartum period, without any form of prior approval.