National Health Law Program Examines Crisis Pregnancy Center Medicaid Billing Practices
The National Health Law Program has published analysis examining the relationship between crisis pregnancy centers and Medicaid reimbursement. CPCs, which typically do not provide abortion, contraception, or comprehensive reproductive health services, may seek Medicaid payment for limited services such as pregnancy tests and ultrasounds. The analysis raises questions about billing practices, scope of services, and regulatory oversight of these facilities within Medicaid programs. The issue affects managed care organizations that may receive claims from CPCs or face questions about network adequacy and covered services for reproductive health.
MCOs may face compliance questions about reimbursing CPC services, network composition for reproductive health, and member access to comprehensive care versus limited pregnancy counseling.
Maternal · Managed Care
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