SF2109 (Legislative Session 94 (2025-2026))
Reimbursement rates provided by birth centers in the medical assistance program modification
Related bill: HF1793
AI Generated Summary
This bill proposes modifications to the reimbursement rates for services provided by birth centers under Minnesota’s Medical Assistance program. It amends section 256B.0625, subdivision 54 of the Minnesota Statutes.
Key provisions include:
Birth Center Services Coverage: Medical Assistance will cover services provided by licensed health professionals in licensed birth centers if the same services would be covered in a hospital.
Facility Payments:
- Currently, facility services at birth centers are reimbursed at the lower of billed charges or 70% of the statewide average hospital facility payment for an uncomplicated vaginal birth.
- If a patient is transferred from a birth center to a hospital prior to delivery, the birth center is paid the lower of billed charges or 15% of that hospital payment rate.
- Changes effective January 1, 2027 (or upon federal approval): Facility payments will increase to 100% of the hospital facility fee cost, both for births at a birth center and cases where the patient is transferred before delivery.
Nursery Care Services:
- Currently reimbursed at the lower of billed charges or 70% of the hospital nursery care rate.
- Changes effective January 1, 2027 (or upon federal approval): Nursery care services at birth centers will be reimbursed at 100% of the average hospital room and board cost.
Midwife Professional Services:
- Licensed traditional midwives will be reimbursed at the lower of billed charges or 100% of the rate paid to a physician for the same service.
- If a patient is transferred before delivery, the midwife who does not perform the delivery cannot bill for delivery services.
- Services by unlicensed midwives will not be covered.
Expanded Reimbursement for Maternal Care:
- Effective January 1, 2027 (or upon federal approval): Birth center providers must be reimbursed for the full range of maternity care services within their scope of practice, regardless of the place of service.
- The commissioner will review and revise current birth center reimbursement practices in consultation with licensed birth centers to ensure comprehensive maternal health services are covered.
Federal Waivers: The commissioner will seek necessary waivers from the Centers for Medicare and Medicaid Services to implement these reimbursement changes.
Overall, this bill aims to increase financial support for birth centers and expand covered maternity care services within these facilities.
Bill text versions
- Introduction PDF file
Actions
Date | Chamber | Where | Type | Name | Committee Name |
---|---|---|---|---|---|
March 02, 2025 | Senate | Floor | Action | Introduction and first reading | |
March 02, 2025 | Senate | Floor | Action | Referred to | Health and Human Services |
April 02, 2025 | Senate | Floor | Action | Author added | |
April 02, 2025 | Senate | Floor | Action | Author added |
Citations
[ { "analysis": { "added": [ "A new reimbursement model based on billed charges or a percentage of the average room and board cost for hospitals." ], "removed": [ "Previous limitations on payment rates for nursery care services." ], "summary": "This bill modifies reimbursement rates for services provided by birth centers in the medical assistance program under section 256B.0625.", "modified": [ "Adjusts payment model for facility services provided by a birth center from 70 percent to 100 percent of the hospital facility fee cost.", "Extends the application of the new payment model to nursery care services." ] }, "citation": "256B.0625" } ]