SIGNED FINAL MOU Quartz Health Solutions, Inc. and Prenatal Care Coordination Agency 4-25-2024

RESPONSIBILITIES OF PRENATAL CARE COORDINATION PROVIDER:

Under this agreement, the Prenatal Care Coordination Agency (“PNCC”) provider will do the following:

1. Designate at least one individual to serve as a liaison between the PNCC provider and Quartz Health Solutions, Inc. (“Quartz”).
2. Share the liaison’s name and contact information with Quartz.
3. Notify Quartz when providing PNCC services to one of its members. (Quartz enrollment information is included in the ForwardHealth Enrollment Verification System.)
4. Contact members referred by Quartz and work diligently to enroll them in PNCC within five days of receiving the referral. This includes the following activities:

• Providing Quartz with the name and contact information of the member’s designated care coordinator.
• Notifying Quartz if the member is determined ineligible or if the member declines PNCC services.

1. Obtain a written Release of Information from all members receiving PNCC services to support the sharing of information with obstetric care providers and other healthcare providers.
2. Send Quartz a completed copy of the Pregnancy Questionnaire within two business days of receiving a request.
3. Share other relevant information with Quartz to coordinate services and help ensure healthy birth outcomes.
4. Consult with the designated Quartz liaison, as needed, on member-specific issues.
5. Provide birth outcome information to Quartz within four weeks of delivery.
6. Participate in meetings, as needed, to evaluate the effectiveness and efficiency of this MOU.