[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-161443-105":3,"detail-sidebar-cat-1-en-105":81,"doc-detail-161443-en":126},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","clinical-policy-home-births-cpmp136","Clinical Policy - Home Births - CP.MP.136","","Clinical Policy CP.MP.136 defines when home births are medically necessary for health plans affiliated with Centene Corporation. It sets requirements for credentialed oversight by a participating provider, including midwife certification and emergency transport within 15 minutes, or physician integration and documented backup arrangements. The policy also lists pregnancy and delivery risk conditions such as no prior cesarean, cephalic presentation, and singleton pregnancy. Planned home birth is considered not medically necessary outside these specified criteria, supported by major medical society guidance and outcome 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is a home birth considered medically necessary under CP.MP.136?","Question",{"text":63,"@type":64},"It is medically necessary when overseen by a participating, credentialed provider and all listed midwife- or physician-specific and clinical criteria are met.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What emergency care requirement applies to home births managed by a midwife?",{"text":68,"@type":64},"The written emergency plan must document that emergency transportation to the nearest appropriate hospital can be accomplished within 15 minutes from onset of an emergency condition.",{"name":70,"@type":61,"acceptedAnswer":71},"What clinical eligibility conditions are required for the pregnancy and labor?",{"text":72,"@type":64},"Requirements include no preexisting conditions increasing pregnancy risk, no prior cesarean delivery, no significant disease during pregnancy, singleton pregnancy, cephalic fetal presentation, and spontaneous labor between at least 38 and no more than 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Log\u0015\nSee \u0013 HYPERLINK \\l \"Important_Reminder\" \u0014Important Reminder\u0015 at the end of this policy for important regulatory and legal information.\nDescription\nA planned home birth is an elective alternative to delivery in a birthing center or hospital setting. Women are encouraged to make medically informed decisions about home delivery, and provision of home births will be considered when coverage is mandated by law or member’s benefit language.\nPolicy/Criteria\nIt is the policy of health plans affiliated with Centene Corporation® that home births are medically necessary when the following criteria are met:\nThe birth is overseen by a participating and credentialed provider of the Plan who meets one of the following criteria:\nIf home birth services are being managed by a midwife, all of the following criteria must be met:\nThe midwife must be certified by the American Midwifery Certification Board (or its predecessor organizations) or the certified nurse–midwife’s, certified midwife’s, or midwife’s education and licensure meet International Confederation of Midwives Global Standards for Midwifery Education;\nThe written plan for emergency care includes documentation that emergency transportation to the nearest appropriate hospital can be accomplished within 15 minutes from the onset of an emergency condition;\nIf home birth services are being managed by a doctor, all of the following must be met:\nThe physician practices obstetrics within an integrated and regulated health system;\nIf the physician is not an obstetrician, there is documented proof of back-up   supervision and coverage by a board certified or an active candidate for certification by the American Board of Obstetrics and Gynecology;\nEmergency care is planned at a facility where the supervising obstetrician has admitting privileges;\nThe facility for emergency care is within 15 minutes by emergency transportation from the site of delivery;\nNo preexisting medical condition(s) that increase pregnancy risk;\nNo prior cesarean delivery;\nAbsence of significant disease during pregnancy;\nA singleton pregnancy;\nFetal presentation is cephalic;\nSpontaneous labor in a pregnancy that has lasted at least 38 weeks but no more than 41 weeks;\nThere is a preexisting arrangement for emergency transportation to a nearby hospital if needed.\nIt is the policy of health plans affiliated with Centene Corporation that home births are considered not medically necessary for any circumstances other than those specified above.\nBackground\nHome birth remains a controversial issue, with safety as the primary focus. Although many countries have established lists based on specific patient characteristics and risks that might compromise the safety of out of hospital births, no specific list exists for the United States.\nPlanned home birth must include a system that allows for collaboration, and referral and transfer to hospital care if problems arise. Appropriate risk screening is paramount in evaluating which home births may lead to positive outcomes. 3, 7\nAmerican College of Obstetricians and Gynecologists (ACOG)\nACOG does not support planned home births given the published medical data and believes that hospitals and birthing centers are the safest settings for birth.  However, ACOG respects the right of a woman to make a medically informed decision about delivery. Women inquiring about planned home birth should be informed of its risks and benefits based on recent evidence. This includes the appropriate selection of candidates for home birth; the appropriate certification for midwifes, as noted in the policy statement; practicing obstetrics within an integrated and regulated health system; ready access to consultation; and access to safe and timely transport to nearby hospitals. Specifically, women should be informed that al","cbCainhC04uxYMOS","https://ap.wps.com/l/cbCainhC04uxYMOS","docx",109210,6,"English","# Coding Implications\n# Revision Log\n# Important Reminder\n# Description\n# Policy/Criteria\n# Background\n# ACOG\n# AAP\n# American College of Nurse Midwives & American Public Health Association\n# World Health Organization","[{\"question\":\"When is a home birth considered medically necessary under CP.MP.136?\",\"answer\":\"It is medically necessary when overseen by a participating, credentialed provider and all listed midwife- or physician-specific and clinical criteria are met.\"},{\"question\":\"What emergency care requirement applies to home births managed by a midwife?\",\"answer\":\"The written emergency plan must document that emergency transportation to the nearest appropriate hospital can be accomplished within 15 minutes from onset of an emergency condition.\"},{\"question\":\"What clinical eligibility conditions are required for the pregnancy and labor?\",\"answer\":\"Requirements include no preexisting conditions increasing pregnancy risk, no prior cesarean delivery, no significant disease during pregnancy, singleton pregnancy, cephalic fetal presentation, and spontaneous labor between at least 38 and no more than 41 weeks.\"}]","Clinical Policy - Home Births - CP.MP.136 | DOCX"]