N.Y. Public Health Law § 2530-a: Payment for prenatal care special services

§ 2530-a. Payment for prenatal care special services. 1. The

commissioner is authorized to establish a program to provide services

under title eleven or title eleven-D of article five of the social

services law, for early and continuous prenatal care for pregnant women

who are eligible to receive services under those titles, to prevent

complications during pregnancy and childbirth and to reduce neonatal

intensive care admissions (referred to in this section as the

"program"). The program shall include the collection, and transmittal to

the department, of health status data pertinent to the management of

pregnancy risk on a health status data form established by the

department.

2. The collection of data under the program shall be based on the

pregnant woman's informed written consent, which shall be in a format

developed by the commissioner and maintained in the provider's medical

record. Participation in the program shall be voluntary for the pregnant

woman. A woman's failure to give consent for the collection of data

under this section or to participate in the program shall not result in

the diminution of any services otherwise available under title eleven or

eleven-D of article five of the social services law.

3. If consent and voluntary participation pursuant to subdivision two

of this section is obtained, providers of prenatal care under title

eleven or title eleven-D of article five of the social services law,

shall endeavor to collect at the earliest possible prenatal visit, and

report to the department in a form and manner determined by the

commissioner, health status data concerning each pregnant woman eligible

for services under title eleven or title eleven-D of article five of the

social services law, and treated by such provider.

4. Upon receipt of a health status data form, the department shall

take one of the following actions:

(a) If the pregnant woman, at the time of the receipt of the health

status data form by the department, is enrolled in a managed care health

plan, the department shall send the form to the plan for triage and

appropriate care management interventions, which shall include available

plan services and referrals for other services available in the

community.

(b) If the pregnant woman, at the time of the receipt of the health

status data form by the department, is not enrolled in a managed care

health plan, the department shall send the form to an entity described

in subdivision five of this section for triage and appropriate care

management services, which shall include, but not be limited to, needed

home visits and referrals to community based services for high risk

pregnant women. If the pregnant woman subsequently becomes enrolled in a

managed care health plan, the designated entity and the plan shall

assure continuity of care.

5. Patient health status data collected under this section shall be

maintained as confidential by the department and by any person or entity

to whom the department discloses the data. Such data may only be

disclosed by the department under this section.

6. For purposes of the activities described in paragraph (b) of

subdivision four of this section, the department is authorized to enter

into agreements with and, within amounts appropriated therefor, provide

funding to, local health departments or not-for-profit organizations to

promote positive pregnancy outcomes, optimal child health, growth and

development, and safe home environments.

7. The department is authorized to operate the program authorized by

this section in a subset of counties in the state.

8. Within amounts appropriated therefor, the commissioner is

authorized to develop fees to reimburse enrolled fee-for-service

providers for the collection and transmittal of clinical data authorized

by this section.