Birth Centers in the Affordable Care Act
Three years after the mandate for reimbursement of the birth center facility service fee and the CPM professional fee was passed in the Affordable Care Act, the mandate has been implemented correctly in fewer than half the states.
What is the mandate for payment?
- The Affordable Care Act required that States provide Medicaid reimbursement for the birth center facility service fees and the professional fees of the birthing attendant.
- This section of the ACA added freestanding birth center (“FSBC”) services, and the professional services of birth attendants in birth centers, as a new category of “medical assistance” under section 1905(a) of the Act.
- This new section also included FSBC services as one of the services mandated by section 1902(a)(10)(A) for Medicaid-enrolled pregnant women.
- Read the text of the law, including effective dates, here.
- Rulemaking: We request that Congress directs CMS to publish rules and regulations for implementation of the payment for birth center facility service fees and the professional fees of the birth attendant.
- Managed Care Organizations (MCOs) – We request that Congress directs CMS to issue policy guidance or rules and regulations to the Medicaid MCOs for mandatory payment.