Page 1 of 2 LRC 2023-BR135-HB54
COMMONWEALTH OF KENTUCKY FISCAL NOTE STATEMENT
LEGISLATIVE RESEARCH COMMISSION
2023 REGULAR SESSION
MEASURE
2023 BR NUMBER 135 HOUSE BILL NUMBER 54
TITLE AN ACT relating to Medicaid coverage for certified professional midwifery services.
SPONSOR Representative Russell Webber
FISCAL SUMMARY
STATE FISCAL IMPACT: YES NO UNCERTAIN
OTHER FISCAL STATEMENT (S) THAT MAY APPLY: ACTUARIAL ANALYSIS
LOCAL MANDATE CORRECTIONS IMPACT HEALTH BENEFIT MANDATE
APPROPRIATION UNIT(S) IMPACTED: Department for Medicaid Services
FUND(S) IMPACTED: GENERAL ROAD FEDERAL RESTRICTED
FISCAL ESTIMATES 2022-2023 2023-2024 ANNUAL IMPACT AT
FULL IMPLEMENTATION
REVENUES
EXPENDITURES $117,800 GF
$274,800 FF
$117,800 GF
$274,800 FF
NET EFFECT ($117,800) GF
($274,800) FF
($117,800) GF
($274,800) FF
( ) indicates a decrease/negative
PURPOSE OF MEASURE: The purpose of the measure is to require Medicaid coverage for
certified midwifery services.
FISCAL EXPLANATION : The Cabinet for Health and Family Services (CHFS) estimates that
the provisions of the legislation would result in increased Medicaid expenditures related to
emergency transportation and neonatal intensive care costs. CHFS notes that, currently, there are
an average of 24,000 births per year in Kentucky, and 1.6 percent of those are home births.
Taking into account the current home birth rate and the average number of births per year, the
Department for Medicaid Services (DMS) estimates there would be at least 384 home births per
year.
Based on available data on intrapartum transport rates, DMS estimates that approximately 130 of
the home births, or about one-third, would require emergency transport to a hospital at a later
stage in delivery at a cost of $20,000 per year. DMS further estimates that approximately 32, or
about 25 percent, of the infants born after the intrapartum transport would need additional care in
the Neonatal Intensive Care Unit (NICU) at an average per stay cost of $11,643, for a total of
$372,576 in NICU costs. Given the anticipated costs for emergency transports and NICU stays, Page 2 of 2 LRC 2023-BR135-HB54
DMS estimates total expenditures of $392,600 per year due to the provisions of the legislation
with $117,800 coming from General Fund and $274,800 coming from Federal Funds.
DATA SOURCE(S): Cabinet for Health and Family Services
PREPARER: Miriam Fordham NOTE NUMBER: 133 REVIEW: JAB DATE: 3/13/2023