907 KAR 1:180. Alternative birth center services.

      RELATES TO: KRS 205.520

      STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1), 205.520(3), 42 C.F.R. 440.170, 42 U.S.C. 1396a, b, d, EO 2004-726

      NECESSITY, FUNCTION, AND CONFORMITY: EO 2004-726, effective July 9, 2004, reorganized the Cabinet for Health Services and placed the Department for Medicaid Services and the Medicaid Program under the Cabinet for Health and Family Services. The Cabinet for Health and Family Services has responsibility to administer the program of Medical Assistance. KRS 205.520(3) empowers the cabinet, by administrative regulation, to comply with any requirement that may be imposed, or opportunity presented, by federal law for the provision of medical assistance to Kentucky's indigent citizenry. This administrative regulation sets forth the coverage provisions for services provided by alternative birth centers for which payment shall be made by the Medicaid Program in behalf of both the categorically needy and the medically needy.

      Section 1. General Provisions. Services shall be covered only when provided to an eligible Medicaid recipient by a participating alternative birth center which is appropriately licensed and operating in accordance with 904 KAR 20:150.

      Section 2. Covered Services. The following services may be provided by alternative birth centers:

      (1) Prenatal visits, to include one (1) initial visit and follow-up visits as appropriate.

      (2) Standby services, with the medical professional (obstetrician or nurse midwife) physically present throughout the course of the labor.

      (3) Delivery, which includes the actual delivery, necessary supplies and material, and the postdelivery examination.

      (4) Postnatal visits, not to exceed two (2) and which shall be accomplished within six (6) weeks of the delivery.

      (5) Laboratory services as specified by the Cabinet for Health and Family Services.

      Section 3. Records, Reporting and Monitoring. The facility shall maintain complete records of services rendered, and provide to the cabinet the records and reports the cabinet requires for the effective implementation and administration of the service. Facility records shall be available to the Cabinet for Health and Family Services, the United States Department of Health and Human Services, and the Comptroller General, and their representatives or designees for auditing or monitoring purposes. (Recodified from 904 KAR 1:180, 5-2-86; Am. 18 Ky.R. 1642; eff. 1-10-92.)