SECTION 354.1252. Certified Nurse Midwife: Conditions for Participation

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.

Source Note: The provisions of this §354.1252 adopted to be effective September 3, 1985, 10 TexReg 3178; amended to be effective September 1, 1988, 13 TexReg 3829; transferred effective September 1, 1993, as published in the Texas Register September 7, 1993, 18 TexReg 5978; transferred effective September 1, 2001, as published in the Texas Register May 24, 2002, 27 TexReg 4561; amended to be effective January 1, 2013, 37 TexReg 9769