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:
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.
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.
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.
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Bill text versions
- Introduction PDF file
Actions
Date | Chamber | Where | Type | Name | Committee Name |
---|---|---|---|---|---|
March 02, 2025 | House | Floor | Action | Introduction and first reading, referred to | Health Finance and Policy |
March 04, 2025 | House | Floor | Action | Author added | |
March 19, 2025 | House | Floor | Action | Author added | |
March 23, 2025 | House | Floor | Action | Author added | |
March 23, 2025 | House | Floor | Action | Author 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" } ]