Congress takes major step toward equitable payment for nurse-midwifery services

On Wednesday, the U.S. House of Representatives passed the "Children's Health and Medicare Protection Act of 2007 (CHAMP)" (H.R.3162), which expands health care coverage to pregnant women and their children and addresses a long-standing inequity in reimbursement for services of certified nurse-midwives (CNMs). The American College of Nurse-Midwives (ACNM) is proud to have endorsed this important legislation and worked hard for its passage.

"H.R.3162 can have a profound impact on health coverage for children and improve women's access to midwifery services under the Medicare program," stated ACNM President Eunice K. M. "Kitty" Ernst, CNM, MPH, DSc(Hon), FACNM. The legislation would ensure that many of our nation's uninsured children have access to vital health care coverage through the State Children's Health Insurance Program (SCHIP). It will also improve access to care for children in underserved areas, help reduce minority health disparities, and protect the Medicare program for the long term.

ACNM especially applauds the provision in the bill eliminating payment limits for CNM services under Medicare dating back to 1988. CNMs are limited to receiving 65% of the Medicare fee, and many Medicaid and private health plans follow Medicare fee schedules, further reducing access to care for vulnerable populations. Under H.R.3126, as of April 1, 2008, CNMs would join the ranks of other health professionals already receiving 100% reimbursement for their services under Medicare, including all physicians (including chiropractors, optometrists, and podiatrists), nurse-anesthetists, audiologists, speech language pathologists, physical therapists, and occupational therapists.

"Expanded access to midwifery care in other countries has produced better outcomes at lower cost and is supported in this country by 80 years of outcomes research on midwifery care," Ernst noted. "Reports and recommendations from both the public and private sector also point to the important role that midwives can play in reducing infant mortality, unnecessary cesarean sections, and routine medical interventions in the normal process of childbirth."

ACNM also supports provisions within the SCHIP portion of the bill that will allow states to apply outreach procedures and programs to all children and pregnant women and provide states the option to expand and add coverage of pregnant women under SCHIP.

"ACNM congratulates the House of Representatives on this tremendous achievement, and celebrates the passionate advocacy of midwives who helped achieve this important victory," said Ernst. "It's critically important that we maintain this momentum to ensure strong support in the Senate for this provision so that it is finally enacted into law," she urged.

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