Midwives urge payment equity under Medicare

Feb 16 2005

Legislation introduced into Congress today would provide for long overdue adjustments to Medicare reimbursement rates for services provided by certified nurse-midwives, according to the American College of Nurse-Midwives (ACNM).

The legislation, titled the “Improving Access to Nurse-Midwifery Care Act,” was introduced by Representative Ed Towns (D-NY) and Representative Fred Upton (R-MI) in the House of Representatives, and by Senator Kent Conrad (D-ND) in the Senate. The bill would also establish recognition for a Certified Midwife (CM) to provide services under Medicare, as legally authorized by state law, as well as make other technical amendments.

“Nurse-midwives provide comparable care, expand access to care, and deserve equal pay,” said Katherine Camacho Carr, CNM, PhD, president of ACNM. “The payment inequity prevents patients from having access to their health care provider of choice, in part because the midwives cannot sustain their practices at a 35 percent discount from what other professionals receive for similar services. ACNM applauds Congressmen Upton and Towns and Senator Conrad for their leadership on this matter.”

The primary effect of the legislation, addressing the payment inequity, was the focus of a Medicare Payment Advisory Committee (MedPAC) report in June of 2002. In a unanimous vote, MedPAC recommended to Congress that the percentage of Part B reimbursement for CNM services be increased. In this same report, MedPAC also stated that research shows the quality of care and outcomes for services provided by CNMs are at least comparable to obstetricians and gynecologists.

Medicare covers approximately 3 million women with disabilities that are of childbearing age. These women give birth to approximately 50,000 infants annually within the program. The legislation will pave the way to allow women with disabilities to choose a midwife as their health care provider and enable more women access to a midwife for well-woman and other primary care services throughout their lifecycle.

For more information about this legislation, contact Patrick Cooney, ACNM Federal Lobbyist, at [email protected] or visit www.midwife.org.

http://www.midwife.org