American Association of Birth Centers Legislative Alert
Payment Crisis Looming ~ Action Needed Immediately
We must get our message about the payment crisis out to Congress immediately and we need everyone to help!
Over the past few years, CMS (the federal agency that runs Medicaid/Medicare) has begun disallowing federal matching funds for state Medicaid payments for freestanding birth centers services. Birth centers have been recognized by CMS (and earlier, by HCFA) as a Medicaid provider type in State Medicaid Plans since 1987. Recently, however, CMS has disallowed such payment by several state Medicaid Agencies, including Alaska, South Carolina, Texas, and Washington State, claiming that it lacks clear statutory authority and direction to do so. CMS has directed its regional offices to stop federal payments to any state for birth center services.
This is not a Medicaid crisis but a payment crisis for birth centers. Historically all payers follow the lead of Medicaid. If Medicaid stops paying the birth center facility fee so will other insurers. We remind you of what happened to the chiropractors in the 1990s. They spent millions to reinstate their coverage.
Make Your Voice Heard – Act Now! 1. Find out who your Congressional Representatives and Senators are. Use these links
2. Make contact – by phone is best (email boxes are clogged with email about the federal bailout of the banks).
Ask to speak to the legislative aide who works on health care issues.
Tell him/her you are a birth center ________ (midwife, owner, consumer, staff person) that provides care to women on Medicaid.
Use the linked flyer Pregnant Women’s Access to Care Threatened as a reference.
1) CMS has stopped paying the facility fee/charges for birth centers in four states and will disallow it in all state plans that come up for review.
2) The federal government has been paying these fees to the states since 1987.
3) The only way to solve this problem is to seek legislation amending Medicaid.
4) Birth centers are part of the vital safety net, especially in rural and urban areas where obstetrical services are closing due to high costs–and many serve a high percentage of women on Medicaid.
5) Birth centers provide innovative approaches to maternity care that reduce disparities for low income and minority women, lower cesarean rates, and reduce health care costs, while increasing access to women on Medicaid..
6) Discuss how your birth center meets some of these needs in your area.
7) Follow the list on the flyer and discuss as many of those points as you want to cover.
8) For a bill, we need sponsors and co-sponsors. Ask if your Senator or Representative is willing to sponsor or co-sponsor the needed legislation to direct CMS to pay facility fees.
a. If they say YES, thank them and direct them to Karen Fennell,
our lobbyist at 301-830-3910 or karenfennell50@ yahoo.com
b. If they say NO, ask them why not and give them Karen’s contact information.
9) Ask for their email so you can send a copy of the flyer Pregnant Women’s Access to Care Threatened. Let them know you will stay in touch with them about this issue, and that you will let them know once our bill has been introduced.
10) If they ask questions you cannot answer, tell them you will have Karen Fennell, our lobbyist contact them.
1) Notify AABC’s lobbyist – Karen Fennell – who you have contacted and where they stand on sponsorship. Also relay any questions from your visit so that Karen can follow-up. Cc: Jill Alliman, AABC’s Legislative Chair, on your correspondence.
2) Send a thank you note, with the flyer Pregnant Women’s Access to Care Threatened. Let them know you will stay in touch with them about this issue, and that you will let them know once the bill has been introduced.
Do not delay. Take action today. It will be hard to be heard with the economic crisis in Congress this week. If enough of us call, they will hear us.
If you have questions about how to make these calls, please let me know.
Please forward this email to your lists.
Jill Alliman, CNM, MSN
American Association of Birth Centers
American Association of Birth Centers | 3123 Gottschall Road | Perkiomenville | PA | 18074
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