1.1 A bill for an act
1.2 relating to human services; modifying reimbursement rates for services provided
1.3 by birth centers in the medical assistance program; amending Minnesota Statutes
1.4 2024, section 256B.0625, subdivision 54.
1.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
1.6 Section 1. Minnesota Statutes 2024, section 256B.0625, subdivision 54, is amended to
1.7read:
1.8 Subd. 54.Services provided in birth centers.(a) Medical assistance covers services
1.9provided in a licensed birth center by a licensed health professional if the service would
1.10otherwise be covered if provided in a hospital.
1.11 (b) Facility services provided by a birth center shall be paid at the lower of billed charges
1.12or 70 percent of the statewide average for a facility payment rate made to a hospital for an
1.13uncomplicated vaginal birth as determined using the most recent calendar year for which
1.14complete claims data is available. If a recipient is transported from a birth center to a hospital
1.15prior to the delivery, the payment for facility services to the birth center shall be the lower
1.16of billed charges or 15 percent of the average facility payment made to a hospital for the
1.17services provided for an uncomplicated vaginal delivery as determined using the most recent
1.18calendar year for which complete claims data is available. This paragraph expires on the
1.19effective date of paragraph (c).
1.20 (c) Effective January 1, 2027, or upon federal approval, whichever is later, facility
1.21services provided by a birth center shall be paid at the lower of billed charges or 100 percent
1.22of the hospital facility fee cost trended to current for an uncomplicated vaginal birth as
1.23determined using the most recent calendar year for which complete claims data is available.
1Section 1.
REVISOR AGW/EH 25-0298102/10/25
State of Minnesota
This Document can be made available
in alternative formats upon request
HOUSE OF REPRESENTATIVES
H. F. No. 1793
NINETY-FOURTH SESSION
Authored by Clardy03/03/2025
The bill was read for the first time and referred to the Committee on Health Finance and Policy 2.1If a recipient is transported from a birth center to a hospital prior to the delivery, the payment
2.2for facility services to the birth center shall be the lower of billed charges or 100 percent of
2.3the hospital facility fee cost trended to current for an uncomplicated vaginal delivery as
2.4determined using the most recent calendar year for which complete claims data is available.
2.5 (c) (d) Nursery care services provided by a birth center shall be paid the lower of billed
2.6charges or 70 percent of the statewide average for a payment rate paid to a hospital for
2.7nursery care as determined by using the most recent calendar year for which complete claims
2.8data is available. This paragraph expires on the effective date of paragraph (e).
2.9 (e) Effective January 1, 2027, or upon federal approval, whichever is later, facility
2.10services provided to a newborn by a birth center shall be paid the lower of billed charges
2.11or 100 percent of the average room and board cost for a hospital stay.
2.12 (d) (f) Professional services provided by traditional midwives licensed under chapter
2.13147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a physician
2.14performing the same services. If a recipient is transported from a birth center to a hospital
2.15prior to the delivery, a licensed traditional midwife who does not perform the delivery may
2.16not bill for any delivery services. Services are not covered if provided by an unlicensed
2.17traditional midwife.
2.18 (g) Effective January 1, 2027, or upon federal approval, whichever is later, birth center
2.19providers must be reimbursed for the full range of maternity care services within their scope
2.20of practice, regardless of place of service. The commissioner must review current birth
2.21center reimbursements and, in consultation with birth centers currently licensed in the state,
2.22develop revisions to current payment practices in order to ensure reimbursement for
2.23comprehensive maternal health services.
2.24 (e) (h) The commissioner shall apply for any necessary waivers from the Centers for
2.25Medicare and Medicaid Services to allow birth centers and birth center providers to be
2.26reimbursed.
2Section 1.
REVISOR AGW/EH 25-0298102/10/25