SLS 23RS-331 REENGROSSED
2023 Regular Session
SENATE BILL NO. 135
BY SENATOR BARROW
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
MEDICAID. Provides relative to Medicaid reimbursement for services provided by a
licensed midwife or certified nurse midwife. (8/1/23)
1 AN ACT
2 To enact R.S. 46:451, relative to Medicaid reimbursement for services of licensed midwives
3 and certified nurse midwives; to provide for a minimum rate of reimbursement
4 relative to physician reimbursement; to provide for legislative findings; to provide
5 for definitions; to provide for eligibility requirements; to provide for approval by
6 CMS; to provide for rulemaking; to provide for prohibited decreases in certain
7 reimbursements; and to provide for related matters.
8 Be it enacted by the Legislature of Louisiana:
9 Section 1. R.S. 46:451 is hereby enacted to read as follows:
10 ยง451. Medicaid reimbursement; midwifery services
11 A. The legislature hereby finds and affirms all of the following:
12 (1) Midwives are community-based practitioners who provide
13 comprehensive, holistic, individualized maternity care and alternative birthing
14 services to low-risk clients.
15 (2) Midwifery care is family-centered and individualized to consider the
16 unique cultural, ethnic, psychosocial, nutritional, and educational needs of the
17 client and supports healthy lifestyle habits that benefit the whole family.
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words in boldface type and underscored are additions. SB NO. 135
SLS 23RS-331 REENGROSSED
1 (3) Midwives have made a tremendous contribution to the health and
2 welfare of mothers and the practice of midwifery continues to advance as a
3 profession as these providers comprise an increasing part of mainstream health
4 care.
5 B. The Louisiana Department of Health shall implement a Medicaid
6 reimbursement rate for midwifery services that is, at a minimum, ninety-five
7 percent of the amount reimbursed to licensed physicians for the provision of the
8 same health services in pregnancy and childbirth when acting within their scope
9 of practice.
10 C. For purposes of this Section, "midwife" means a licensed midwife
11 licensed by the Louisiana State Board of Medical Examiners pursuant to R.S.
12 37:3240 et seq. or a certified nurse midwife licensed by the Louisiana State
13 Board of Nursing pursuant to R.S. 37:913.
14 D.(1) The midwife shall be enrolled as a Medicaid provider and be a
15 managed care organization network or a fee for service provider in the
16 Medicaid program in order to be reimbursed in accordance with this Section.
17 (2) Implementation of the reimbursement rate provided for in this
18 Section shall be subject to approval by the Centers for Medicare and Medicaid
19 Services.
20 (3) The Louisiana Department of Health may promulgate any rules as
21 may be necessary to implement the provisions of this Section.
22 E.(1) Nothing in this Section shall be construed to require a decrease in
23 any reimbursement rate for midwife services that are reimbursed equal to the
24 amount reimbursed to licensed physicians.
25 (2) Nothing in this Section shall be construed to expand, diminish, or
26 alter the scope of practice of a midwife.
27 (3) Nothing in this Section shall be construed to require the Medicaid
28 program to cover any specific healthcare service.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 135
SLS 23RS-331 REENGROSSED
The original instrument was prepared by Brandi Cannon. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Tracy Sabina Sudduth.
DIGEST
SB 135 Reengrossed 2023 Regular Session Barrow
Proposed law provides that the La. Dept. of Health shall implement a Medicaid
reimbursement rate for services by licensed midwives or certified nurse midwives that is,
at a minimum, 95% of the amount reimbursed to licensed physicians for the provision of the
same health services in pregnancy and childbirth, when acting within their scope of practice.
Proposed law defines "midwife".
Proposed law requires the midwife to be enrolled as a Medicaid provider and be a managed
care organization network or fee for service provider in the Medicaid program in order to
be reimbursed in accordance with proposed law.
Proposed law is subject to approval by the Centers for Medicare and Medicaid Services.
Proposed law shall not be construed to do any of the following:
(1)Require a decrease in any reimbursement rate for midwife services that are
reimbursed equal to the amount reimbursed to licensed physicians.
(2)Expand, diminish, or alter the scope of practice of a midwife.
(3)Require Medicaid to cover any specific healthcare service.
Effective August 1, 2023.
(Adds R.S. 46:451)
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Health and Welfare to
the original bill
1. Increase the minimum reimbursement from 90% to 95% of the amount
reimbursed to licensed physicians.
2. Specify that services must be within the scope of practice for midwives.
3. Extend applicability to both licensed midwives and certified nurse midwives.
4. Extend applicability to a midwife enrolled as a Medicaid fee for service
provider.
5. Make technical changes.
Summary of Amendments Adopted by Senate
Committee Amendments Proposed by Senate Committee on Finance to the
engrossed bill
1. Makes a technical amendment.
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.