HF1793 (Legislative Session 94 (2025-2026))

Reimbursement rates for services provided by birth centers in the medical assistance program modified.

Related bill: SF2109

AI Generated Summary

This bill proposes modifications to the reimbursement rates for services provided by licensed birth centers under Minnesota's medical assistance program.

Key Changes:

  1. Current Reimbursement Rates:

    • Facility services at birth centers are currently reimbursed at 70% of the statewide average facility payment rate made to hospitals for uncomplicated vaginal births.
    • If a recipient is transferred from a birth center to a hospital before delivery, the birth center is reimbursed 15% of the average hospital facility payment for an uncomplicated vaginal birth.
    • Nursery care services at birth centers are currently reimbursed at 70% of the average hospital payment for nursery care.
    • Licensed traditional midwives working in birth centers are reimbursed at 100% of the rate paid to physicians for the same services. However, if a patient is transferred before delivery, the midwife cannot bill for delivery services.
  2. Future Increases in Reimbursement (Effective January 1, 2027, or Upon Federal Approval):

    • Facility services at birth centers will be reimbursed at 100% of the hospital facility fee cost for uncomplicated vaginal births (instead of the current 70% rate).
    • If a patient is transferred to a hospital before delivery, the birth center will still be reimbursed 100% of the hospital facility fee cost for an uncomplicated vaginal birth.
    • Nursery care services at birth centers will be reimbursed at 100% of the average room and board cost for a hospital stay (instead of the current 70% rate).
    • Birth center providers will receive reimbursement for the full range of maternity care services covered within their scope of practice, regardless of where the services are provided.
    • The Minnesota Department of Human Services Commissioner must review and revise current reimbursement practices in consultation with licensed birth centers to ensure comprehensive maternal health services reimbursement.
  3. Federal Compliance:

    • The commissioner is instructed to apply for any necessary waivers from the Centers for Medicare and Medicaid Services (CMS) to ensure these reimbursement changes can be implemented.

Summary:

This bill increases reimbursement rates for birth center services under Minnesota’s medical assistance program. By 2027 (or upon federal approval), birth centers will be reimbursed at 100% of hospital rates for facility and nursery care services, and providers will receive full reimbursement for maternity care services within their scope. The bill also mandates a review of current reimbursement structures to ensure comprehensive coverage.


Would you like a more concise version, or do you need any specific details explained further?

Bill text versions

Actions

DateChamberWhereTypeNameCommittee Name
March 02, 2025HouseFloorActionIntroduction and first reading, referred toHealth Finance and Policy
March 04, 2025HouseFloorActionAuthor added
March 19, 2025HouseFloorActionAuthor added
March 23, 2025HouseFloorActionAuthor added
March 23, 2025HouseFloorActionAuthor added

Citations

 
[
  {
    "analysis": {
      "added": [
        "New payment structures for facility services in birth centers effective January 1, 2027, or upon federal approval.",
        "Reimbursement protocols for professional services by traditional midwives."
      ],
      "removed": [],
      "summary": "This bill modifies reimbursement rates for services provided by birth centers in the medical assistance program, under section 256B.0625, subdivision 54.",
      "modified": [
        "Changes to reimbursement rates for services in licensed birth centers."
      ]
    },
    "citation": "256B.0625"
  }
]