NJ
"HealthStart
Maternity Care Services Obstetrical Services
V. Risk
Management
The
obstetrical care provider shall determine the appropriate management of
care including specialized consultation and/or transferring the patient's
care to another facility and/or provider. This shall be documented
in the patient's record. The obstetrical care provider shall inform
the pediatrician of identified risk factors that may have significant impact
on the fetus…" New Jersey Contract, Attachment 3, pages 11-15.
PA
"G. DIFFERENTLY
ACCESSED SERVICES...
The PCP must
furnish primary care to members who are enrolled with them, and serve as
gateopeners and gatekeepers for access to most other types of services,
with the exception of ... the first prenatal visit to an appropriate specialist,
such as an OB/GYN or nurse midwife...Once chosen and approved by the HMO,
the maternity care provider can then refer the member for all medically
necessary pregnancy-related services and consults. However, the HMO must
ensure that coordination occurs between the PCP and the obstetrician or
nurse midwife…" Pennsylvania RFP, page 49.