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 354.1253 - Licensed Midwife: Conditions for Participation

(1) the LM is licensed and approved by the Texas Midwifery Board under Chapter 203 of the Occupations Code and 22 TAC Chapter 831 (relating to Midwifery);

(2) the LM who performs the service is enrolled in and approved for participation in the Texas Medicaid Program;

(3) the service:

(4) the service is one of the following:

(5) the service is not duplicative of any other service charged to the Texas Medicaid Program.

(1) HHSC does not reimburse an LM for conducting childbirth education classes.

(2) HHSC reimburses only the LM actually performing the covered service.

(1) Upon enrollment in the Texas Medicaid program, an LM must inform HHSC in writing of the identity of a licensed physician or group of physicians (the "referral physician or group") with whom the LM has arranged for referral and consultation in the event of medical complications and submit a letter from the licensed physician or physician group affirming that agreement. For purposes of this section, "consultation" means discussion of patient status, care, and management.

(2) If the arrangement changes or if the LM selects a new referral physician or group, the LM must, within ten business days of the change or new selection, notify HHSC in writing of the new referral physician or group's identity and submit a letter from the licensed physician or physician group affirming that agreement.

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