NEWBORN ENROLLMENTS Sample Clauses
NEWBORN ENROLLMENTS. The Contractor agrees to enroll and provide coverage for eligible newborn children of Enrollees effective from the time of birth. SDOH Responsibilities:
1. The SDOH will update WMS with information on the newborn received from hospitals, consistent with the requirements of Section 366-g of the Social Services Law as amended by Chapter 412 of the Laws of 1999. APPENDIX H October 1, 2004 H-4
2. Upon notification of the birth by the hospital or birthing center, the SDOH will update WMS with the demographic data for the newborn and enroll the newborn in the mother's MCO if not already enrolled. The newborn will be retroactively enrolled back to the first (1st) day of the month of birth. Based on the transaction date of the enrollment of the newborn on the PCP subsystem, the newborn will appear on either the next month's roster or the subsequent month's roster. On plan rosters for upstate and NYC, the "PCP Effective From Date" will indicate the first day of the month of birth, as described in 01 OMM/ADM 5 "Automatic Medicaid Enrollment for Newborns." LDSS Responsibilities:
1. Grant Medicaid eligibility for newborns for one (1) year if born to a woman eligible for and receiving MA assistance on the date of birth. (SOCIAL SERVICES LAW SECTION 366 (4) (1))
2. LDSS must add eligible unborns to all WMS cases that include a pregnant woman as soon as the pregnancy is medically verified. (NYS DSS ADMINISTRATIVE DIRECTIVE 85 ADM-33)
3. In the event that the LDSS learns of an Enrollee's pregnancy prior to the Contractor, the LDSS is to establish MA eligibility and enroll the unborn in the Contractor's plan.
4. The LDSS is responsible for newborn enrollment should it not be successfully competed under the "SDOH Responsibilities" process as outlined in #2 above.
5. When a newborn is enrolled in managed care, the LDSS must send an Enrollment Confirmation Notice to inform the mother of the Effective Date of Enrollment, which is the first (1st) day of the month of birth, and the plan in which the newborn is enrolled.
6. The LDSS may develop a transmittal form to be used for unborn/newborn notification between the Contractor and the LDSS.
NEWBORN ENROLLMENTS a) The Contractor agrees to enroll and provide coverage for eligible newborn children effective from the time of birth.
NEWBORN ENROLLMENTS. The Contractor agrees to enroll and provide coverage for eligible newborn children of Enrollees effective from the time of birth: SDOH Responsibilities:
1. The SDOH will update WMS with information on the newborn received from hospitals, consistent with the requirements of Section 366-g of the Social Services Law as amended by Chapter 412 of the Laws of 1999. APPENDIX H OCTOBER 1, 2004 H-4
2. Upon NOTIFICATION of the birth by the hospital or birthing center, the SDOH will update WMS with the demographic data for the newborn and enroll the newborn in ________________________________________________________________ ______________ date of the enrollment of the newborn on the PCP subsystem; the newborn will appear on either the next month's roster or the subsequent month's roster. On plan rosters for upstate and NYC, the "PCP Effective Froth Date" will indicate the first day of the month of birth, as described in 01 OMNI/ADMS "Automatic Medicaid Enrollment for Newborns." LDSS Responsibilities:
NEWBORN ENROLLMENTS a) The Contractor agrees to enroll and provide coverage for eligible newborn children effective from the time of birth. APPENDIX H October 1, 2005 H-5
b) SDOH Responsibilities:
i) The SDOH will update WMS with information on the newborn received from hospitals, consistent with the requirements of Section 366-g of the SSL as amended by Chapter 412 of the Laws of 1999.
ii) Upon notification of the birth by the hospital or birthing center, the SDOH will update WMS with the demographic data for the newborn and enroll the newborn in the mother's MCO if the newborn is not already enrolled, the mother's MCO offers a MMC product, and the newborn is not identified as SSI or SSI-related and therefore Excluded from the MMC Program pursuant to Section 2(b)(xi) of this Appendix. The newborn will be retroactively enrolled back to the first (1st) day of the month of birth. Based on the transaction date of the Enrollment of the newborn on the PCP subsystem, the newborn will appear on either the next month's Roster or the subsequent month's Roster. On Rosters for upstate and NYC, the "PCP Effective From Date" will indicate the first day of the month of birth, as described in 01 OMM/ADM 5 "Automatic Medicaid Enrollment for Newborns." If the newborn's Enrollment is not completed by this process, the LDSS is responsible for Enrollment (see (c)(iv) below).
NEWBORN ENROLLMENTS