Minnesota Administrative Rules

9505.0353 PRENATAL CARE SERVICES.

Subpart 1.

Definitions.

For purposes of this part, the terms in items A to F have the meanings given them.

A.

"At risk" refers to the recipient who requires additional prenatal care services because of a health condition that increases the probability of a problem birth or the delivery of a low birth weight infant. The term includes "at risk of poor pregnancy outcome" and "at high risk of poor pregnancy outcome."

B.

"Prenatal care management" means the development, coordination, and ongoing evaluation of a plan of care for an at risk recipient by a physician or registered nurse on a one to one basis.

C.

"Prenatal care services" refers to the total array of medically necessary health services provided to an at risk recipient during pregnancy. The services include those necessary for pregnancy and those additional services that are authorized in this part.

D.

"Nutrition counseling" means services provided by a health care professional with specialized training in prenatal nutrition education to assess and to minimize the problems hindering normal nutrition in order to improve the recipient's nutritional status during pregnancy.

E.

"Prenatal education" means services provided to recipients at risk of poor pregnancy outcomes by a health care professional with specialized training in instructing at risk recipients how to change their lifestyles, develop self care and parenting skills, and recognize warning signs of preterm labor and childbirth.

F.

"Risk assessment" means identification of the medical, genetic, lifestyle, and psychosocial factors which identify recipients at risk of poor pregnancy outcomes.

Subp. 2.

Risk assessment.

To be eligible for medical assistance payment, a provider of prenatal care services shall complete a risk assessment for a recipient for whom the services are provided. The risk assessment must be completed at the recipient's first prenatal visit.

Subp. 3.

Additional service for at-risk recipients.

The services in items A to C shall be provided to a recipient if the recipient's risk assessment identifies the services as medically necessary because of her at-risk status.

A.

Prenatal care management must include:

(1)

development of an individual plan of care that addresses the recipient's specific needs related to the pregnancy;

(2)

ongoing evaluation and, if appropriate, revision of the plan of care according to the recipient's needs related to pregnancy;

(3)

assistance to the recipient in identifying, obtaining, and using services specified in the recipient's plan of care;

(4)

monitoring, coordinating, and managing nutrition counseling and prenatal education services to assure that these are provided in the most economical, efficient, and effective manner.

B.

Nutrition counseling includes:

(1)

assessing the recipient's knowledge of nutritional needs in pregnancy;

(2)

determining the areas of the recipient's dietary insufficiency;

(3)

instructing the recipient about her nutritional needs during pregnancy;

(4)

developing an individual nutrition plan, if indicated, including referral to community resources which assist in providing adequate nutrition.

C.

Prenatal education includes:

(1)

information and techniques for a healthy lifestyle during pregnancy, including stress management, exercise, and reduction or cessation of drug, alcohol, and cigarette use;

(2)

instruction about preterm labor, warning signs of preterm labor, and appropriate methods to delay labor; and

(3)

information about the childbirth process, parenting, and additional community resources as appropriate to the individual recipient.

Statutory Authority:

MS s 256B.04

History:

12 SR 624; 30 SR 1318

Published Electronically:

August 12, 2013