SF 2109

Introduction - 94th Legislature (2025 - 2026)

Posted on 07/09/2025 09:10 a.m.

A bill for an act
relating to human services; modifying reimbursement rates for services provided
by birth centers in the medical assistance program; amending Minnesota Statutes
2024, section 256B.0625, subdivision 54.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2024, section 256B.0625, subdivision 54, is amended to
read:

Subd. 54.

Services provided in birth centers.

(a) Medical assistance covers services
provided in a licensed birth center by a licensed health professional if the service would
otherwise be covered if provided in a hospital.

(b) Facility services provided by a birth center shall be paid at the lower of billed charges
or 70 percent of the statewide average for a facility payment rate made to a hospital for an
uncomplicated vaginal birth as determined using the most recent calendar year for which
complete claims data is available. If a recipient is transported from a birth center to a hospital
prior to the delivery, the payment for facility services to the birth center shall be the lower
of billed charges or 15 percent of the average facility payment made to a hospital for the
services provided for an uncomplicated vaginal delivery as determined using the most recent
calendar year for which complete claims data is available. new text begin This paragraph expires on the
effective date of paragraph (c).
new text end

new text begin (c) Effective January 1, 2027, or upon federal approval, whichever is later, facility
services provided by a birth center shall be paid at the lower of billed charges or 100 percent
of the hospital facility fee cost trended to current for an uncomplicated vaginal birth as
determined using the most recent calendar year for which complete claims data is available.
If a recipient is transported from a birth center to a hospital prior to the delivery, the payment
for facility services to the birth center shall be the lower of billed charges or 100 percent of
the hospital facility fee cost trended to current for an uncomplicated vaginal delivery as
determined using the most recent calendar year for which complete claims data is available.
new text end

deleted text begin (c) deleted text end new text begin (d) new text end Nursery care services provided by a birth center shall be paid the lower of billed
charges or 70 percent of the statewide average for a payment rate paid to a hospital for
nursery care as determined by using the most recent calendar year for which complete claims
data is available. new text begin This paragraph expires on the effective date of paragraph (e).
new text end

new text begin (e) Effective January 1, 2027, or upon federal approval, whichever is later, facility
services provided to a newborn by a birth center shall be paid the lower of billed charges
or 100 percent of the average room and board cost for a hospital stay.
new text end

deleted text begin (d) deleted text end new text begin (f) new text end Professional services provided by traditional midwives licensed under chapter
147D shall be paid at the lower of billed charges or 100 percent of the rate paid to a physician
performing the same services. If a recipient is transported from a birth center to a hospital
prior to the delivery, a licensed traditional midwife who does not perform the delivery may
not bill for any delivery services. Services are not covered if provided by an unlicensed
traditional midwife.

new text begin (g) Effective January 1, 2027, or upon federal approval, whichever is later, birth center
providers must be reimbursed for the full range of maternity care services within their scope
of practice, regardless of place of service. The commissioner must review current birth
center reimbursements and, in consultation with birth centers currently licensed in the state,
develop revisions to current payment practices in order to ensure reimbursement for
comprehensive maternal health services.
new text end

deleted text begin (e) deleted text end new text begin (h) new text end The commissioner shall apply for any necessary waivers from the Centers for
Medicare and Medicaid Services to allow birth centers and birth center providers to be
reimbursed.