N.M. Code R. § 8.308.9.16 - REPRODUCTIVE HEALTH SERVICES
The benefit package includes reproductive health services as detailed in 8.310.2 NMAC. The MCO shall implement written policies and procedures approved by HSD which define how a member is educated about his or her rights to family planning services, freedom of choice, to include access to non-contract providers, and methods for accessing family planning services.
A. The family planning
policy shall ensure that a member of the appropriate age of both sexes who
seeks family planning services shall be provided with counseling pertaining to
the following:
(1) human immunodeficiency
virus (HIV) and other sexually transmitted diseases and risk reduction
practices; and
(2) birth control
pills and devices including plan B and long acting reversible
contraception.
B. The
MCO shall provide a member with sufficient information to allow them to make
informed choices including the following:
(1)
types of family planning services available;
(2) the member's right to access these
services in a timely and confidential manner;
(3) freedom to choose a qualified family
planning provider who participates in the MCO network or from a provider who
does not participate in the member's MCO network; and
(4) if a member chooses to receive family
planning services from a non-contracted provider, the member shall be
encouraged to exchange medical information between the PCP and the
non-contracted provider for better coordination of care.
C.
Pregnancy termination
procedures: The benefit package includes services for the termination of
a pregnancy as detailed in 8.310.2 NMAC. Medically necessary pregnancy
terminations which do not meet the requirements of
42
CFR 441.202 are excluded from the capitation
payment made to the MCO and shall be reimbursed solely from state funds
pursuant to the provisions of 8.310.2 NMAC.
Notes
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