§ 42-12.3-3 - Medical assistance expansion for pregnant women/RIte Start.
SECTION 42-12.3-3
§ 42-12.3-3 Medical assistance expansionfor pregnant women/RIte Start. – (a) The director of the department of human services is authorized to amend itstitle XIX state plan pursuant to title XIX of the Social Security Act toprovide Medicaid coverage and to amend its title XXI state plan pursuant toTitle XXI of the Social Security Act to provide medical assistance coveragethrough expanded family income disregards for pregnant women whose familyincome levels are between one hundred eighty-five percent (185%) and twohundred fifty percent (250%) of the federal poverty level. The department isfurther authorized to promulgate any regulations necessary and in accord withtitle XIX [42 U.S.C. § 1396 et seq.] and title XXI [42U.S.C. § 1397 et seq.] of the Social Security Act necessary in orderto implement said state plan amendment. The services provided shall be inaccord with title XIX [42 U.S.C. § 1396 et seq.] and title XXI[42 U.S.C. § 1397 et seq.] of the Social Security Act.
(b) The director of the department of human services isauthorized and directed to establish a payor of last resort program to coverprenatal, delivery and postpartum care. The program shall cover the cost ofmaternity care for any woman who lacks health insurance coverage for maternitycare and who is not eligible for medical assistance under title XIX [42U.S.C. § 1396 et seq.] and title XXI [42 U.S.C. § 1397 etseq.] of the Social Security Act including, but not limited to, anon-citizen pregnant woman lawfully admitted for permanent residence on orafter August 22, 1996, without regard to the availability of federal financialparticipation, provided such pregnant woman satisfies all other eligibilityrequirements. The director shall promulgate regulations to implement thisprogram. Such regulations shall include specific eligibility criteria; thescope of services to be covered; procedures for administration and servicedelivery; referrals for non-covered services; outreach; and public education.Excluded services under this paragraph will include, but not be limited to,induced abortion except to prevent the death of the mother.
(c) The department of human services may enter intocooperative agreements with the department of health and/or other stateagencies to provide services to individuals eligible for services undersubsections (a) and (b) above.
(d) The following services shall be provided through theprogram:
(1) Ante-partum and postpartum care;
(2) Delivery;
(3) Cesarean section;
(4) Newborn hospital care;
(5) Inpatient transportation from one hospital to anotherwhen authorized by a medical provider;
(6) Prescription medications and laboratory tests;
(e) The department of human services shall provide enhancedservices, as appropriate, to pregnant women as defined in subsections (a) and(b), as well as to other pregnant women eligible for medical assistance. Theseservices shall include: care coordination, nutrition and social servicecounseling, high risk obstetrical care, childbirth and parenting preparationprograms, smoking cessation programs, outpatient counseling for drug-alcoholuse, interpreter services, mental health services, and home visitation. Theprovision of enhanced services is subject to available appropriations. In theevent that appropriations are not adequate for the provision of these services,the department has the authority to limit the amount, scope and duration ofthese enhanced services.
(f) The department of human services shall provide forextended family planning services for up to twenty-four (24) months postpartum.These services shall be available to women who have been determined eligiblefor RIte Start or for medical assistance under title XIX [42 U.S.C. §1396 et seq.] or title XXI [42 U.S.C. § 1397 et seq.] ofthe Social Security Act.