When Medicaid expansion became effective July 1, 2023, pregnant women in the previously limited coverage pregnancy group were transitioned to a full coverage benefits group which meant more resources could be put towards the care of mothers for their overall health, not just for pregnancy related needs. In addition, the postpartum coverage group was transitioned to a full coverage group with 12 months of coverage. To continue the trend of putting more focus and resources into care for healthy moms, (not just pregnancy care) South Dakota Medicaid has created a pregnancy focused care management program that went live April 1, 2024. As of April 1, 112 providers have enrolled to participate in this program.
The Pregnancy Program is intended to improve maternal health outcomes through enhanced care coordination, services being provided in accordance with standards of care, and reducing barriers to care. Participating providers are eligible for enhanced reimbursement for care coordination and meeting prenatal care and postpartum care program objectives.
The program objectives include:
- Increase utilization of prenatal and postpartum care.
- Provide and connect pregnant and postpartum women with supports.
- Improve health outcomes for pregnant women and their babies.
Eligible providers include:
- Physicians
- Physician Assistants
- Certified Nurse Practitioners
- Certified Nurse Midwives
- Rural Health Clinics
- Federally Qualified Health Centers
- Indian Health Services (IHS) and Tribal 638 Providers
For more information, please check out the South Dakota Department of Social Services (DSS) page.
