Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 354 - MEDICAID HEALTH SERVICES
Subchapter A - PURCHASED HEALTH SERVICES
Division 16 - MIDWIFE SERVICES
Section 354.1252 - Certified Nurse Midwife: Conditions for Participation

Universal Citation: 1 TX Admin Code ยง 354.1252

Current through Reg. 49, No. 38; September 20, 2024

Subject to the specifications, conditions, requirements, and limitations established by the Texas Health and Human Services Commission or its designee (HHSC), nurse-midwife services that are provided by a certified nurse-midwife (CNM) are a covered benefit under the Texas Medicaid Program and are subject to the following conditions.

(1) The CNM provides nurse-midwife services according to:

(A) requirements in §354.1251 of this division (relating to Benefits and Limitations); and

(B) provisions of the state plan.

(2) The CNM must be enrolled and approved for participation in the Texas Medicaid Program. A CNM must be a licensed registered nurse who is approved by the Texas Board of Nursing as an advanced practice registered nurse in nurse-midwifery and who is also certified by the American College of Nurse-Midwives.

(3) To participate in the Texas Medicaid Program, a CNM must identify a licensed physician or group of physicians with whom an arrangement has been made for referral and consultation in the event of medical complications. For purposes of this section, "consultation" means discussion of patient status, care, and management.

(A) If the collaborating physician or group is not participating in the Texas Medicaid Program, the CNM must inform recipients of their potential financial responsibility according to the requirements of the Texas Medicaid Program applicable to all Medicaid providers.

(B) If and when the arrangement is changed or cancelled, the CNM must, within ten business days of the cancellation or change, notify HHSC in writing of the identity of the new physician or group and submit a letter from the licensed physician or physician group affirming that agreement.

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