Judge Rules Against Birth Centers
May 2009 - A federal administrative judge has ruled that the federal Medicaid program may deny federal funds to state Medicaid plans that pay for birth center facility fees. The ruling comes in an appeal by the Texas Health & Human Services Commission in which the American Association of Birth Centers (AABC) filed an amicus brief on behalf of the 42 Texas birth centers that are now at risk to lose Medicaid payment of their costs. The decision leaves the federal Centers for Medicare and Medicaid Services ("CMS") free to shut down birth center facility reimbursement in the rest of the U.S.
The AABC has turned to Congress to rectify this situation. Legislation that would require payment to birth centers on the same basis that Medicaid currently pays hospitals, physicians, and nurse-midwives will be introdouced in the U.S. House of Representatives next week by Representative Susan Davis (D) of California and Representative Gus Bilirakis (R) of Florida. The bill, to be called the "Birth Center Medicaid Act," would ensure that Medicaid enrollees may continue to access the safe, woman-centered, cost-effective care that women with private insurance may choose.
For the past 30 years, birth centers have consistently demonstrated dramatic cost savings, compared to the cost of childbirth in hospitals. According to data from the U.S. Agency for Healthcare Research and Quality, and the recently-published Milbank report, "Evidence-based Maternity Care: What It Is and What It Can Achieve", the national average charge for an uncomplicated hospital birth is four times higher than for birth in a freestanding birth center. Birth centers provide high quality woman-centered care with outcomes as good if not better than hospital births, result in far fewer expensive interventions, and demonstrate much lower rates of cesarean sections.
Even though birth centers had been recognized as Medicaid providerss by CMS (and, earlier, by HCFA) since 1987, in the last three years CMS began to disallow federal matching funds to states that paid birth center facilitiy fees. As a result, state Medicaid Agencies in Alaska, South Carolina, and Washington State were forced to find alternative ways to compensate birth centers for Medicaid enrollees. The Texas Health & Human Services Commission has not yet indicated whether it intends to pursue a further appeal to the courts, but AABC is greatly concerned that the agency may be not continue to pay birth centers without federal matching funds.
The nationwide implications of this ruling, not only for women enrolled in Medicaid but also for birth centers, could be catastrophic. Birth centers serve a significant Medicaid population and, for some centers, as many as 50% to 95% of patients are Medicaid enrollees. Without reimbursement for the costs associated with these births, birth centers thoughout the nation will be pushed to the brink of closing. Some centers in Washington State have, in fact, been forced to close since the CMS crackdown. The loss of birth centers would be particularly ironic at the present time, as the nation considers how to deal with a flu pandemic that could make hospitals unsuitable sites for women in labor and their otherwise-healthy babies. Birth centers, in such a scenario, stand out as safe havens where women could give birth safely without exposure to hospital pathogens. If birth centers are forced to shut their doors because of this misguided CMS policy, this option may be foreclosed in many states.
For further information, and to learn how you can take action, please visit AABC's Legislative Alert pages on www.BirthCenters.org
*taken from American Association of Birth Centers' website
oh, wow. thanks for passing along this info, ann.
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