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<regulation prefix="Regulation" num=".08" citation="COMAR 10.67.04.08" title_num="10" subtitle_num="67" chapter_num="04" heading="Special Needs Populations — Pregnant and Postpartum Women.">
  <paragraph num="A.">
    <text>An MCO shall meet the standards set forth in this regulation for treating pregnant and postpartum women.</text>
  </paragraph>
  <paragraph num="B.">
    <text>An MCO shall ensure access to prenatal care for pregnant women and postpartum care for postpartum women by:</text>
    <paragraph num="(1)">
      <text>Scheduling an appointment for the first prenatal visit and seeing the woman within 10 days of request;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Scheduling an appointment for a postpartum woman and seeing the woman within 10 days of request:</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Arranging for an adequate network of providers including obstetricians, gynecologists, perinatologists, neonatologists, anesthesiologists, and advanced practice nurses who are capable of addressing complex maternal and infant health issues; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Linking a pregnant woman with a pediatric provider before delivery.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>An MCO shall ensure that prenatal providers:</text>
    <paragraph num="(1)">
      <text>Complete a prenatal risk assessment, using an instrument approved by the Department, at the first prenatal visit; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Within 10 days of completing the prenatal risk assessment, forward this instrument to the local health department in the jurisdiction in which the pregnant enrollee lives.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>The Department may not include questions about a woman's HIV infection status on the prenatal risk assessment instrument.</text>
  </paragraph>
  <paragraph num="E.">
    <text>An MCO shall refer pregnant and postpartum women with a substance use disorder to the behavioral health ASO for substance use treatment within 24 hours of request.</text>
  </paragraph>
  <paragraph num="F.">
    <text>An MCO shall refer pregnant and postpartum women, infants, and children younger than 5 years old to the WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) Program, and shall provide to WIC necessary medical information to determine WIC nutritional eligibility.</text>
  </paragraph>
  <paragraph num="G.">
    <text>An MCO shall follow, at a minimum, the American College of Obstetricians and Gynecologists (ACOG) guidelines for pregnant and postpartum women.</text>
  </paragraph>
  <paragraph num="H.">
    <text>An MCO shall provide risk-related medical and nonmedical preventive treatment services, including nutrition counseling by licensed nutritionists or dietitians and smoking cessation education and treatment for pregnant and postpartum women.</text>
  </paragraph>
  <paragraph num="I.">
    <text>An MCO shall provide HIV counseling, including a risk assessment and information about possible transmission of HIV to the fetus.</text>
  </paragraph>
  <paragraph num="J.">
    <text>An MCO shall offer its pregnant and postpartum enrollees voluntary HIV counseling and testing following the requirements of COMAR 10.67.06.</text>
  </paragraph>
  <paragraph num="K.">
    <text>An MCO shall arrange for the appropriate emergency transfer of pregnant women, newborns, and infants to tertiary care centers.</text>
  </paragraph>
</regulation>