Sponsored by:
Assemblywoman PAMELA R. LAMPITT
District 6 (Burlington and Camden)
Assemblywoman ELIANA PINTOR MARIN
District 29 (Essex)
Assemblywoman GABRIELA M. MOSQUERA
District 4 (Camden and Gloucester)
Co-Sponsored by:
Assemblywoman Downey and Assemblyman Armato
SYNOPSIS
Codifies current requirements regarding completion of Perinatal Risk Assessment form by certain Medicaid health care providers.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning the Perinatal Risk Assessment form and supplementing Title 30 of the Revised Statutes.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. An obstetrical provider, nurse midwife, or other licensed health care professional, approved as a provider under the Medicaid program established pursuant to P.L.1968, c.413 (C.30:4D-1 et seq.), shall complete the Perinatal Risk Assessment form, as used by the Division of Medical Assistance and Health Services in the Department of Human Services, for each pregnant Medicaid recipient who receives prenatal care from the provider. The form shall be completed by the provider during the recipient’s first prenatal visit.
2. The division shall require providers to submit each Perinatal Risk Assessment form completed pursuant to section 1 of this act to the division, or to a nonprofit entity contracted by the division to process and maintain the Perinatal Risk Assessment data. A provider shall not receive authorization for reimbursement for prenatal services provided to a pregnant Medicaid recipient until a Perinatal Risk Assessment form is submitted for that recipient.
3. The division, in collaboration with the Department of Health, Medicaid managed care organizations, and any nonprofit entity contracted by the division to process and maintain the Perinatal Risk Assessment data, shall analyze the Perinatal Risk Assessment data in order to identify trends in the risk factors associated with Medicaid recipients during pregnancy. The division shall submit a written report 18 months following the enactment of this act, and annually thereafter, to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), providing a summary of their findings, and any proposals for legislative action needed to improve the maternal outcomes of Medicaid recipients.
4. The Commissioners of Health and Human Services, pursuant to the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt rules and regulations necessary to implement the provisions of this act.
5. This act shall take effect immediately.
STATEMENT
This bill codifies current requirements regarding the completion of the Perinatal Risk Assessment form by certain Medicaid health care providers. Specifically, under the bill, an obstetrical provider, nurse midwife, or other licensed health care professional, approved as a provider under the Medicaid program, is required to complete the Perinatal Risk Assessment form, as used by the Division of Medical Assistance and Health Services in the Department of Human Services, for each pregnant Medicaid recipient who receives prenatal care from the provider. The provider is required to complete the form during the recipient’s first prenatal visit.
Furthermore, the bill directs the division to require providers to submit each completed Perinatal Risk Assessment form to the division, or to a nonprofit entity contracted by the division to process and maintain the Perinatal Risk Assessment data. The bill stipulates that a provider will not receive authorization for reimbursement for prenatal services provided to a pregnant Medicaid recipient until a Perinatal Risk Assessment form is submitted for that recipient. Currently, the Perinatal Risk Assessment form serves as an authorization for payment to providers from Medicaid managed care organizations.
The bill also requires the division, in collaboration with the Department of Health, Medicaid managed care organizations, and any nonprofit entity contracted by the division to process and maintain the Perinatal Risk Assessment data, to analyze the Perinatal Risk Assessment data in order to identify trends in the risk factors associated with Medicaid recipients during pregnancy. The bill directs the division to submit a written report 18 months following the enactment of this bill, and annually thereafter, to the Governor and to the Legislature, providing a summary of their findings and any proposals for legislative action needed to improve the maternal outcomes of Medicaid recipients.
The Perinatal Risk Assessment form allows the division to gather information about Medicaid-eligible pregnant women in New Jersey via a common risk assessment tool. To achieve this goal, the form content includes all of the demographic, medical, and psychosocial factors considered in the risk management of pregnant women. As used currently, and unchanged by this bill, the Perinatal Risk Assessment form is intended to promote early and accurate identification of prenatal risk factors, and to reduce administrative burden on obstetric practices. In addition, the form is also used as a mechanism to refer eligible families to evidence-based home visiting programs, as well as access to prenatal care initiative projects focused on improving access to prenatal care and other related services.
It is the sponsor’s belief that codifying current requirements regarding the completion of the Perinatal Risk Assessment form by Medicaid providers who deliver prenatal services will strengthen the division’s ability to use this tool to gather the essential information needed to improve prenatal services provided to Medicaid beneficiaries.