[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 864 Introduced in House (IH)]
110th CONGRESS
1st Session
H. R. 864
To amend title XVIII of the Social Security Act to provide for
reimbursement of certified midwife services and to provide for more
equitable reimbursement rates for certified nurse-midwife services.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
February 6, 2007
Mr. Towns (for himself and Mr. Upton) introduced the following bill;
which was referred to the Committee on Ways and Means, and in addition
to the Committee on Energy and Commerce, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to provide for
reimbursement of certified midwife services and to provide for more
equitable reimbursement rates for certified nurse-midwife services.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Midwifery Care Access and
Reimbursement Equity Act of 2007''.
SEC. 2. FINDINGS.
Congress finds the following:
(1) The Medicare program reimburses certified nurse-
midwives for primary care services, as authorized by State law.
(2) Since 1988, Congress has authorized reimbursement under
the Medicare program to certified nurse-midwives for the
provision of maternity-related services to Medicare-eligible
women with disabilities who are of childbearing age.
(3) Since 1993, Congress authorized reimbursements under
the Medicare program to certified nurse-midwives to also
provide additional services outside the maternity cycle.
(4) In its June 2002 report to Congress, the Medicare
Payment Advisory Commission (MedPAC) unanimously recommended
that the percentage of part B reimbursement for certified
nurse-midwife services to be increased by Congress. MedPAC also
highlighted the high quality of care provided by certified
nurse-midwives.
(5) Certified nurse-midwives and certified midwives are
highly educated health professionals. To practice in the United
States as either a certified nurse-midwife or a certified
midwife, an individual must complete a post-baccalaureate
educational program and State licensure as well as pass a
national certification examination.
(6) While most State Medicaid programs reimburse certified
nurse midwives and other obstetrical and gynecological
providers at the same payment rate, the Medicare program
reimburses such midwives at a payment rate that is 35 percent
lower than such other providers.
(7) This disparity is a barrier to women's access to
obstetrical and gynecological providers of their choice within
the Medicare program.
(8) Health disparities in the United States continue to be
a critical problem. Midwives have historically cared for those
populations most at risk for health disparities in areas of
high infant mortality, preterm birth, low birth weight, sudden
infant death syndrome, maternal mortality, breast and cervical
cancer, and HIV/AIDS infection among women.
(9) Providing more equitable reimbursement for the high
quality primary care services of certified nurse-midwives and
certified midwives will aid in ensuring their services are
available to women in need.
SEC. 3. MEDICARE PAYMENT FOR CERTIFIED NURSE-MIDWIFE AND MIDWIFE
SERVICES.
(a) Certified Midwife, Certified Midwife Services Defined.--(1)
Section 1861(gg) of the Social Security Act (42 U.S.C. 1395x(gg)) is
amended by adding at the end the following new paragraphs:
``(3) The term `certified midwife services' means such services
furnished by a certified midwife (as defined in paragraph (4)) and such
services and supplies furnished as an incident to the certified
midwife's service which the certified midwife is legally authorized to
perform under State law (or the State regulatory mechanism provided by
State law) as would otherwise be payable under this title if furnished
by a physician or as an incident to a physician's service.
``(4) The term `certified midwife' means an individual who has
successfully completed a bachelor's degree from an accredited
educational institution and a program of study and clinical experience
meeting guidelines prescribed by the Secretary, or has been certified
by an organization recognized by the Secretary.''.
(2) The heading in section 1861(gg) of the Social Security Act (42
U.S.C. 1395x(gg)) is amended to read as follows:
``(gg) Certified Nurse-Midwife Services; Certified Midwife
Services.--''.
(b) Certified Midwife Service Benefit.--
(1) Medical and other services.--Section 1861(s)(2)(L) of
the Social Security Act (42 U.S.C. 1395x(s)(2)(L)) is amended
by inserting ``and certified midwife services'' before the
semicolon.
(2) Permitting hospitals to provide for patients receiving
certified nurse-midwife services or certified midwife services
to be under the care of a certified nurse-midwife or certified
midwife.--Section 1861(e)(4) of the Social Security Act (42
U.S.C. 1395x(e)(4)) is amended--
(A) by inserting ``(i)'' after ``except that''; and
(B) by inserting before the semicolon the
following: ``and (ii) a patient receiving certified
nurse-midwife services or certified midwife services
(as defined in paragraphs (1) and (3), respectively, of
subsection (gg)) may be under the care of a certified
nurse-midwife or certified midwife with respect to such
services to the extent permitted under State law''.
(3) Benefit under part b.--Section 1832(a)(2)(B)(iii) of
the Social Security Act (42 U.S.C. 1395k(a)(2)(B)(iii)) is
amended--
(A) by inserting ``(I)'' after ``(iii)''; and
(B) by inserting ``certified midwife services,''
after ``certified nurse-midwife services,''.
(4) Amount of payment.--Section 1833(a)(1)(K) of the Social
Security Act (42 U.S.C. 1395l(a)(1)(K)) is amended--
(A) by inserting ``and certified midwife services''
after ``certified nurse-midwife services'', and
(B) by striking ``65 percent'' and inserting ``100
percent'' each place it appears.
SEC. 4. INTERIM, FINAL REGULATIONS.
In order to carry out the amendments made by this Act in a timely
manner, not later than 6 months after the date of the enactment of this
Act, the Secretary of Health and Human Services shall promulgate
regulations, that take effect on an interim basis, after notice and
pending opportunity for public comment.
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