37.86.3405    TARGETED CASE MANAGEMENT SERVICES FOR HIGH RISK PREGNANT WOMEN, COVERAGE

(1) Reimbursable targeted case management services for high risk pregnant women are:

(a) comprehensive assessment and periodic reassessment;

(b) care plan development;

(c) care coordination and referral for other services; and

(d) monitoring and follow up.

(2) Face-to-face comprehensive assessments must occur at least monthly during the pregnancy.

(3) Two post-partum reassessments must occur after delivery prior to the last day of the month in which the 60th day following delivery occurs.

(4) Monitoring must include at least one annual monitoring to determine if the following conditions are met:

(a) services are being furnished in accordance with the member's care plan;

(b) services in the care plan are adequate; and

(c) changes in the needs or status of the member are reflected in the care plan.

 

History: 53-6-113, MCA; IMP, 53-6-101, MCA; NEW, 1991 MAR p. 1295, Eff. 7/26/91; TRANS, from SRS, 2000 MAR p. 481; AMD, 2017 MAR p. 1906, Eff. 10/14/17.