AABC Works on Lasting and Universal Solutions
The American Association of Birth Centers (AABC) announced today that they have filed a petition with the federal Centers for Medicare and Medicaid Services (CMS) to intervene in a hearing regarding CMS’ recent disallowance of Medicaid payment for birth center facility charges by the Texas Health & Human Services Commission, the Texas Medicaid agency. If successful, this will allow AABC to represent birth centers located in Texas, and to call witnesses in the hearing, which will be held in autumn of 2008. The CMS disallowance means that the federal government would withhold federal "matching" funds from Texas Medicaid for birthing center facility fees, obligating Texas Medicaid to pay the entire amount out of state funds, which it may not be willing to do.
Because CMS has never before disallowed matching funds for birth center facility charges for the past twenty years, it is unclear why they have now disallowed payment for such charges. The South Carolina Medicaid agency has also recently stated that it will no longer reimburse facility charges for birth centers there due to CMS’ disallowance of such charges, but has apparently chosen not to contest the disallowance as Texas has.
Services and providers that are eligible for Medicaid reimbursement are contained in Section 1905 of the Social Security Act. One solution would be a Congressional amendment of that Act to name birth centers specifically as a covered service. This has been a long term goal of AABC, but so far legislative work has been slow, because AABC and its constituents are small and lack leverage.
This threat to reimbursement by Medicaid is one that AABC and its member birth centers cannot allow to go unanswered. Over 50% of birth centers in the U.S. accept Medicaid clients. In many rural areas, over 70% of women giving birth have Medicaid coverage for their pregnancies. Some of the Texas birth centers that will lose reimbursement of facility fees if the present challenge is unsuccessful have Medicaid client populations as high as 80 to 95%. Because other insurance companies tend to follow the example of Medicaid in their reimbursement decisions, even birth centers that do not accept Medicaid are likely to be affected by this decision. Therefore, AABC calls on all birth centers and those who support the birth center concept to join with them to support this important work to create a permanent solution for birth center facility payment.
AABC requests that you make a donation to the AABC Foundation's Birth Center Defense Fund to help with the legal fees. So far, filing this petition with all the work involved has cost $5,000 but this is only the beginning. It is important
that we use this opportunity to work for a lasting and universal solution for all, so it is not necessary to fight this costly battle in each state—one-by-one. Every contribution is important and we are grateful for donations of all sizes.
Donate now to this cause today, and if you are not yet a member of AABC, please join in this fight for access to care in birth centers for women on Medicaid, and for ALL women!
April 25, 2008
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