INFORMATION ALERT: Certified Professional Midwives and Birth Center Provisions in the Affordable Care Act

MAMA Campaign Leaders Meet with the Center for Medicare & Medicaid Services (CMS)

MAMA Campaign representatives met on April 6th by conference call with key staff members of the Centers for Medicare and Medicaid Services (CMS) to discuss implementation of the birth center provisions in last year's health care law and how they pertain to CPMs. We were pleased to hear about the agency's long-awaited guidance to the states regarding the implementation of these provisions.  In particular, the MAMA Campaign wanted to discuss the requirement for Medicaid reimbursement of the provider fee as it would apply to licensed CPMs delivering care in licensed birth centers. 

The MAMA Campaign wants to share the information gained from this discussion with CMS, so that you will understand how CMS plans to implement these provisions with the states.  If you are a licensed CPM providing services in a licensed birth center, we encourage you to reach out to your state Medicaid officials to discuss their plans to implement the payment of the provider fee for these services.  MAMA stands ready to answer your questions or assist you in these discussions in your state.

During this meeting with CMS, the MAMA Campaign was assured that: 

• Certified Professional Midwife (CPM) services will be treated as mandatory providers for purposes of Federal Medicaid matching payments, provided such services are furnished in a State-recognized freestanding birth center.
     
• States must first submit to CMS amendments to their State Medicaid plans in order to comply with this provision (and to subsequently receive Federal Medicaid matching payments). 

Mary Lawlor and Ida Darragh at CMS Headquarters

Background and Explanation

On March 25, 2011, CMS released an informational bulletin providing guidance to states on implementation of section 2301 of the Affordable Care Act (ACA).  As stated in the CMS bulletin, section 2301 of the ACA "requires States that recognize freestanding birth centers to provide coverage and separate payments for freestanding birth center facility services and services rendered by certain professionals providing services in a freestanding birth center, to the extent the State licenses or otherwise recognizes such providers under State law."   

In follow-up conversations with CMS officials, the MAMA Campaign further understands that CMS will soon be sharing with States, through CMS Regional Offices, a State Plan Amendment (SPA) template, which will enumerate in more detail the types of professionals that are eligible for federal Medicaid matching payments under this provision.  In particular, the MAMA Campaign has been assured that this guidance specifies that Certified Professional Midwife (CPM) services, provided such services are furnished in a State-recognized freestanding birth center, will be treated as mandatory providers for purposes of Federal Medicaid matching payments. 

Although the provision took effect upon the enactment of ACA (March 23, 2010) - unless in unique instances when State legislation may be first required to effectuate the Federal change - States must first submit to CMS amendments to their State Medicaid plans in order to comply with this provision (and to subsequently receive Federal Medicaid matching payments).  CMS staff has assured us that they intend to expeditiously review these amendments. 

The MAMA Campaign further understands that, as of the date of writing, at least three states (WA, MN, and TX) plus Guam, have already received CMS approval and have begun to take advantage of the federal Medicaid matching payments for this provision.  The MAMA Campaign expects the remaining States that recognize freestanding birth centers and CPMs to submit their State Plan Amendments to CMS, hopefully in the next State Plan Amendment review quarter ending June 30, 2011.

Moving Forward

The MAMA Campaign is happy to address any questions you may have about the CMS guidance and we stand ready to be of assistance as your states put this guidance into effect.  Please feel free to contact MAMA Policy Analyst, Mary Lawlor, CPM, at president@nacpm.org if you have any questions about how this guidance may apply in your state.

The MAMA Campaign is grateful for these provisions in ACA that will ensure Medicaid reimbursement for licensed CPMs providing services in licensed birth centers.  The recently introduced HR 1054, the Access to Certified Professional Midwives Act of 2011 will, when passed, ensure Medicaid reimbursement of all licensed CPM services in all settings. 

NACPM encourages your support of MAMA.

The NACPM Board of Directors