Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1117 Compare Versions

Only one version of the bill is available at this time.

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2	2	HOUSE DOCKET, NO. 2842 FILED ON: 1/16/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1117
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Manny Cruz and Lindsay N. Sabadosa
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act promoting and enhancing the sustainability of birth centers and the midwifery workforce.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Manny Cruz7th Essex1/16/2025Natalie M. Higgins4th Worcester2/3/2025Susannah M. Whipps2nd Franklin2/12/2025David Paul Linsky5th Middlesex2/13/2025Bruce E. TarrFirst Essex and Middlesex2/26/2025Christopher J. Worrell5th Suffolk3/6/2025Kevin G. Honan17th Suffolk3/7/2025 1 of 12
16	16	HOUSE DOCKET, NO. 2842 FILED ON: 1/16/2025
17	17	HOUSE . . . . . . . . . . . . . . . No. 1117
18	18	By Representatives Cruz of Salem and Sabadosa of Northampton, a petition (accompanied by
19	19	bill, House, No. 1117) of Manny Cruz, Natalie M. Higgins and others relative to coverage of
20	20	birth centers and the midwifery workforce. Financial Services.
21	21	The Commonwealth of Massachusetts
22	22	_______________
23	23	In the One Hundred and Ninety-Fourth General Court
24	24	(2025-2026)
25	25	_______________
26	26	An Act promoting and enhancing the sustainability of birth centers and the midwifery workforce.
27	27	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
28	28	of the same, as follows:
29	29	1 SECTION 1. Chapter 10 of the General Laws are hereby amended by inserting after
30	30	2section 35TTT the following section:-
31	31	3 Section 35UUU. (a) There shall be established and set up on the books of the
32	32	4commonwealth a separate fund known as the Midwifery Workforce Development Fund. The
33	33	5fund shall be administered by the secretary of the executive office of health and human services
34	34	6in consultation with the advisory committee established pursuant to subsection (d); provided, that
35	35	7the secretary may delegate administration of part or all of the fund to an organization
36	36	8representing certified professional midwives. There shall be credited to the fund: (i) revenue
37	37	9from appropriations or other money authorized by the general court and specifically designated
38	38	10to be credited to the fund; (ii) federal grants and other federal funds designated for maternal
39	39	11health; (iii) interest earned on such revenues; and (iv) all other funds from public and private
40	40	12sources credited or transferred into the fund, including gifts, public or private grants, settlements 2 of 12
41	41	13and donations. Any unexpended balance in the fund at the end of a fiscal year shall not revert to
42	42	14the General Fund and shall remain available for expenditure in subsequent fiscal years. No
43	43	15expenditure made from the fund shall cause the fund to become deficient at any point. Any fiscal
44	44	16year-end balance in the fund that is subject to appropriation shall not be subject to section 5C of
45	45	17chapter 29. The fund shall not be subject to appropriation.
46	46	18 (b) Expenditures from the fund shall be used for:
47	47	19 (i) providing assistance to students in education and training programs to qualify them to
48	48	20become licensed certified professional midwives, including, but not limited to:
49	49	21 (A) program costs, tuition, books and fees related to the cost of education and training for
50	50	22participants in training and educational programs, including distance learning programs and
51	51	23including tuition and other costs related to obtaining a midwifery degree or Midwifery Bridge
52	52	24Certificate;
53	53	25 (B) costs related to obtaining an applicable license, including, but not limited to,
54	54	26examination and licensing fees;
55	55	27 (C) stipends for program participants; and
56	56	28 (D) stipends for childcare and transportation for program participants;
57	57	29 (ii) a student loan forgiveness program for certified professional midwives and certified
58	58	30nurse midwives; provided, that the program may require participants to practice in an
59	59	31underserved area or serve marginalized populations, as defined by the secretary in consultation
60	60	32with the advisory committee; 3 of 12
61	61	33 (iii) a grant program to fund local initiatives supporting the development of educational
62	62	34programs for certified professional midwives;
63	63	35 (iv) retention of practicing midwives, and mental health and psychosocial support for
64	64	36certified professional midwives and certified nurse midwives; and
65	65	37 (v) with the approval of the advisory committee, other purposes consistent with the goals
66	66	38of the fund.
67	67	39 (c) Annually, not later than December 1, the secretary of health and human services shall
68	68	40report on the activities of the fund to the clerks of the house of representatives and the senate and
69	69	41to the house and senate committees on ways and means and the joint committee on children,
70	70	42families and persons with disabilities. The report shall include: (i) an accounting of expenditures
71	71	43made from the fund with a description of the authorized purpose of each expenditure; (ii) an
72	72	44accounting of amounts credited to the fund; and (iii) any unexpended balance remaining in the
73	73	45fund. The report may also include analysis and recommendations prepared by the advisory
74	74	46committee, which may include recommendations for changes to this section. The report shall be
75	75	47published on the public web site of the executive office of health and human services or the
76	76	48department of public health.
77	77	49 (d) There shall be an advisory committee to make recommendations concerning the
78	78	50operation and expenditures of the fund. The advisory committee that shall consist of the
79	79	51following members: a representative of the Massachusetts chapter of the National Association of
80	80	52Certified Professional Midwives, who shall serve as chair, a representative of the American
81	81	53College of Nurse Midwives; a member of the Pregnancy, Infancy and Early Childhood Division
82	82	54of the Department of Public Health; a representative of the Massachusetts League of Community 4 of 12
83	83	55Health Centers; and the following members chosen by the chair: a representative of a midwifery
84	84	56educational program; a representative of a community college; a representative of an
85	85	57organization concerned about reproductive justice and health equity; a representative of a safety-
86	86	58net hospital; and a representative of a free-standing birth center.
87	87	59 SECTION 2. Chapter 32A of the General Laws is hereby amended by inserting after
88	88	60section 17W the following sections:-
89	89	61 Section 17X. (a) The commission shall ensure that the rate of payment for services
90	90	62provided to an active or retired employee of the commonwealth who is insured under the group
91	91	63insurance commission that are rendered by a certified nurse-midwife authorized to engage in the
92	92	64practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C of
93	93	65chapter 112 that is within the scope of the certified nurse-midwife's authorization to practice
94	94	66shall be no less than the payment rate for the same service if performed by a physician,
95	95	67regardless of the site of services, or length of stay.
96	96	68 (b) The commission shall ensure that the rate of payment for services for services
97	97	69provided to an active or retired employee of the commonwealth who is insured under the group
98	98	70insurance that are rendered by a licensed certified professional midwife authorized to engage in
99	99	71the practice of midwifery by the board of registration in midwifery pursuant to section 110 of
100	100	72chapter 13 that is within the scope of the licensed certified professional midwife's authorization
101	101	73to practice shall be no less than the payment rate for the same service if performed by a
102	102	74physician, regardless of the site of services, or length of stay.
103	103	75 Section 17Y. The commission shall ensure that the rate of payment for services provided
104	104	76to an active or retired employee of the commonwealth who is insured under the group insurance 5 of 12
105	105	77commission that are rendered by or within a licensed freestanding birth center regulated under
106	106	78section 51M of chapter 111, including newborn care and care provided prior to an intrapartum
107	107	79transfer to another facility, shall be no less than the payment rate for the same services if
108	108	80performed at a hospital, regardless of the site of services, or length of stay. Such payment shall
109	109	81include a reasonable facility fee to be negotiated between the birth center and the commission;
110	110	82provided, that the facility fee shall be no less than a minimum fee amount determined by the
111	111	83department of public health in consultation with the center for health information and analysis,
112	112	84the health policy commission, and operators and prospective operators of birth centers in the
113	113	85commonwealth.
114	114	86 SECTION 3. The third paragraph of section 10A of chapter 118E of the General Laws, as
115	115	87inserted by section 40 of chapter 186 of the acts of 2024, is hereby amended by adding the
116	116	88following sentences:- The payment rate for a service provided by a licensed certified
117	117	89professional midwife that is within the scope of the licensed certified professional midwife’s
118	118	90authorization to practice shall be no less than the payment rate for the same service if performed
119	119	91by a physician, regardless of the site of services. The payment rate for services provided by or
120	120	92within a licensed freestanding birth center regulated under section 51M of chapter 111, including
121	121	93newborn care and care provided prior to an intrapartum transfer to another facility, shall be no
122	122	94less than the payment rate for the same services if performed at a hospital, regardless of site of
123	123	95services or length of stay. Such payment shall include a reasonable facility fee to be negotiated
124	124	96between the birth center and the division; provided, that the facility fee shall be no less than a
125	125	97minimum fee amount determined by the department of public health in consultation with the
126	126	98center for health information and analysis, the health policy commission, and operators and
127	127	99prospective operators of birth centers in the commonwealth. 6 of 12
128	128	100 SECTION 4. Chapter 175 of the General Laws is hereby amended by inserting after
129	129	101section 47YY the following sections:-
130	130	102 Section 47ZZ. (a) A policy, contract, agreement, plan or certificate of insurance issued,
131	131	103delivered or renewed within or without the commonwealth shall provide that the rate of payment
132	132	104for services rendered by a certified nurse-midwife authorized to engage in the practice of nurse-
133	133	105midwifery by the board of registration in nursing pursuant to section 80C of chapter 112 that is
134	134	106within the scope of the certified nurse-midwife's authorization to practice shall be no less than
135	135	107the payment rate for the same service if performed by a physician, regardless of the site of
136	136	108services, or length of stay.
137	137	109
138	138	110 (b) A policy, contract, agreement, plan or certificate of insurance issued, delivered or
139	139	111renewed within or without the commonwealth shall provide that the rate of payment for services
140	140	112rendered by a licensed certified professional midwife authorized to engage in the practice of
141	141	113midwifery by the board of registration in midwifery pursuant to section 110 of chapter 13 that is
142	142	114within the scope of the licensed certified professional midwife's authorization to practice shall be
143	143	115no less than the payment rate for the same service if performed by a physician, regardless of the
144	144	116site of services, or length of stay.
145	145	117 Section 47AAA. A policy, contract, agreement, plan or certificate of insurance issued,
146	146	118delivered or renewed within or without the commonwealth shall provide that the rate of payment
147	147	119for services rendered by or within a licensed freestanding birth center regulated under section
148	148	12051M of chapter 111, including newborn care and care provided prior to an intrapartum transfer to
149	149	121another facility, shall be no less than the payment rate for the same services if performed at a 7 of 12
150	150	122hospital, regardless of the site of services, or length of stay. Such payment shall include a
151	151	123reasonable facility fee to be negotiated between the birth center and the payer; provided, that the
152	152	124facility fee shall be no less than a minimum fee amount determined by the department of public
153	153	125health in consultation with the center for health information and analysis, the health policy
154	154	126commission, and operators and prospective operators of birth centers in the commonwealth.
155	155	127 SECTION 5. Chapter 176A of the General Laws is hereby amended by inserting after
156	156	128section 8ZZ the following sections:-
157	157	129 Section 8AAA. (a) A contract between a subscriber and the corporation under an
158	158	130individual or group hospital service plan that is delivered, issued or renewed within or without
159	159	131the commonwealth shall provide that the rate of payment for services rendered by a certified
160	160	132nurse-midwife authorized to engage in the practice of nurse-midwifery by the board of
161	161	133registration in nursing pursuant to section 80C of chapter 112 that is within the scope of the
162	162	134certified nurse-midwife's authorization to practice shall be no less than the payment rate for the
163	163	135same service if performed by a physician, regardless of the site of services.
164	164	136
165	165	137 (b) A contract between a subscriber and the corporation under an individual or group
166	166	138hospital service plan that is delivered, issued or renewed within or without the commonwealth
167	167	139shall provide that the rate of payment for services rendered by a licensed certified professional
168	168	140midwife authorized to engage in the practice of midwifery by the board of registration in
169	169	141midwifery pursuant to section 110 of chapter 13 that is within the scope of the licensed certified
170	170	142professional midwife's authorization to practice shall be no less than the payment rate for the
171	171	143same service if performed by a physician, regardless of the site of services, or length of stay. 8 of 12
172	172	144 Section 8BBB. A contract between a subscriber and the corporation under an individual
173	173	145or group hospital service plan that is issued, delivered or renewed within or without the
174	174	146commonwealth shall provide that the rate of payment for services rendered by or within a
175	175	147licensed freestanding birth center regulated under section 51M of chapter 111, including
176	176	148newborn care and care provided prior to an intrapartum transfer to another facility, shall be no
177	177	149less than the payment rate for the same services if performed at a hospital, regardless of the site
178	178	150of services, or length of stay. Such payment shall include a reasonable facility fee to be
179	179	151negotiated between the birth center and the payer; provided, that the facility fee shall be no less
180	180	152than a minimum fee amount determined by the department of public health in consultation with
181	181	153the center for health information and analysis, the health policy commission, and operators and
182	182	154prospective operators of birth centers in the commonwealth.
183	183	155 SECTION 6. Chapter 176B of the General Laws is hereby amended by inserting after
184	184	156section 4ZZ the following sections:-
185	185	157 Section 4AAA. (a) Any subscription certificate under an individual or group medical
186	186	158service agreement that is delivered, issued or renewed within the commonwealth shall provide
187	187	159that the rate of payment for services rendered by a certified nurse-midwife authorized to engage
188	188	160in the practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C
189	189	161of chapter 112 that is within the scope of the certified nurse-midwife's authorization to practice
190	190	162shall be no less than the payment rate for the same service if performed by a physician,
191	191	163regardless of the site of services.
192	192	164 9 of 12
193	193	165 (b) Any subscription certificate under an individual or group medical service agreement
194	194	166that is delivered, issued or renewed within the commonwealth shall provide that the rate of
195	195	167payment for services rendered by a licensed certified professional midwife authorized to engage
196	196	168in the practice of midwifery by the board of registration in midwifery pursuant to section 110 of
197	197	169chapter 13 that is within the scope of the licensed certified professional midwife's authorization
198	198	170to practice shall be no less than the payment rate for the same service if performed by a
199	199	171physician, regardless of the site of services, or length of stay.
200	200	172 Section 4BBB. Any subscription certificate under an individual or group medical service
201	201	173agreement that is issued, delivered or renewed within or without the commonwealth shall
202	202	174provide that the rate of payment for services rendered by or within a licensed freestanding birth
203	203	175center regulated under section 51M of chapter 111, including newborn care and care provided
204	204	176prior to an intrapartum transfer to another facility, shall be no less than the payment rate for the
205	205	177same services if performed at a hospital, regardless of the site of services, or length of stay. Such
206	206	178payment shall include a reasonable facility fee to be negotiated between the birth center and the
207	207	179payer; provided, that the facility fee shall be no less than a minimum fee amount determined by
208	208	180the department of public health in consultation with the center for health information and
209	209	181analysis, the health policy commission, and operators and prospective operators of birth centers
210	210	182in the commonwealth.
211	211	183 SECTION 7. Chapter 176G of the General Laws is hereby amended by inserting after
212	212	184section 4RR the following sections:-
213	213	185 Section 4SS. (a) Any individual or group health maintenance contract that is issued or
214	214	186renewed within or without the commonwealth shall provide that the rate of payment for services 10 of 12
215	215	187rendered by a certified nurse-midwife authorized to engage in the practice of nurse-midwifery by
216	216	188the board of registration in nursing pursuant to section 80C of chapter 112 that is within the
217	217	189scope of the certified nurse-midwife's authorization to practice shall be no less than the payment
218	218	190rate for the same service if performed by a physician, regardless of the site of services, or length
219	219	191of stay.
220	220	192 (b) Any subscription certificate under an individual or group medical service agreement
221	221	193that is delivered, issued or renewed within the commonwealth shall provide that the rate of
222	222	194payment for services rendered by a licensed certified professional midwife authorized to engage
223	223	195in the practice of midwifery by the board of registration in midwifery pursuant to section 110 of
224	224	196chapter 13 that is within the scope of the licensed certified professional midwife's authorization
225	225	197to practice shall be no less than the payment rate for the same service if performed by a
226	226	198physician, regardless of the site of services, or length of stay.
227	227	199 Section 4TT. Any individual or group health maintenance contract that is issued,
228	228	200delivered or renewed within or without the commonwealth shall provide that the rate of payment
229	229	201for services rendered by or within a licensed freestanding birth center regulated under section
230	230	20251M of chapter 111, including newborn care and care provided prior to an intrapartum transfer to
231	231	203another facility, shall be no less than the payment rate for the same services if performed at a
232	232	204hospital, or length of stay. Such payment shall include a reasonable facility fee to be negotiated
233	233	205between the birth center and the payer; provided, that the facility fee shall be no less than a
234	234	206minimum fee amount determined by the department of public health in consultation with the
235	235	207center for health information and analysis, the health policy commission, and operators and
236	236	208prospective operators of birth centers in the commonwealth. 11 of 12
237	237	209 SECTION 8. (a) No later than 12 months after the effective date of this act, the
238	238	210department of public health shall establish licensing requirements, plan review checklists and
239	239	211facility guidelines specific for birth centers that reflect the particular needs of birth centers and
240	240	212low-risk childbearing people. The requirements and guidelines shall be developed in consultation
241	241	213with operators of birth centers in the commonwealth, people involved with the development of
242	242	214prospective birth centers in the commonwealth, and groups concerned with improving birth
243	243	215outcomes, midwifery and birth centers, including, but not limited to, the American College of
244	244	216Nurse-Midwives, the National Association of Certified Professional Midwives, the American
245	245	217Association of Birth Centers, and the Commission for the Accreditation of Birth Centers.
246	246	218 (b) No later than 90 days after the effective date of this act, the department of public
247	247	219health shall waive plan review fees for birth centers which demonstrate substantial financial
248	248	220hardship. The department shall issue guidelines and an application process for birth centers
249	249	221seeking a waiver of plan review fees under this subsection; provided, that the guidelines and
250	250	222application process shall be developed in consultation with operators of birth centers in the
251	251	223commonwealth, people involved with the development of prospective birth centers in the
252	252	224commonwealth, and groups concerned with improving birth outcomes, midwifery and birth
253	253	225centers, including, but not limited to, the American College of Nurse-Midwives and the National
254	254	226Association of Certified Professional Midwives.
255	255	227 SECTION 9. No later than 18 months after the effective date of this act, the department
256	256	228of public health, or a third party designated by the department, shall participate in the
257	257	229Community Birth Data Registry organized by the Foundation for Health Care Quality, or an
258	258	230equivalent validated national data collection registry, for the purposes of quality improvement 12 of 12
259	259	231and research, and direct all midwives in the commonwealth to record data on community births
260	260	232with the registry.
261	261	233 Aggregate data as defined by the Board of Registration in Midwifery and as collected by
262	262	234the registry shall be made available to the Department of Public Health Vital Records Division,
263	263	235and shall be included in reports on births and birth outcomes reported by the department.
264	264	236Researchers who meet reasonable standards and who have passed an appropriate ethics review
265	265	237established by the department may have access to data collected by the registry. Confidential
266	266	238birth data involving identifiable individuals shall under no circumstances be used to determine
267	267	239whether a person is eligible for a license, privilege, right, grant, or benefit, or whether such
268	268	240should be revoked. No individual or entity may query the dataset for purposes of investigation or
269	269	241discipline.
270	270	242 No later than 6 months after the effective date of this act, the department of public health
271	271	243shall issue a report on progress towards establishing a community birth data registry in
272	272	244Massachusetts. The report shall identify any barriers identified by the department, how the
273	273	245department intends to overcome the barriers, and the cost to the Commonwealth and midwives
274	274	246and birth centers of participation. The report shall be filed with the house and senate committees
275	275	247on ways and means and the joint committees on public health and children, families and persons
276	276	248with disabilities, and published on the web site of the department.
277	277	249 For the purposes of this section, the term “community births” shall mean a birth that is
278	278	250planned to occur in a home, birth center, or other location other than a hospital, and including
279	279	251those that involve or include transfer to a hospital.