HF1793

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.

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