ACNM Policy Update - 2/25/2014
1. ACNM Submits Comments on Marketplace
"Letter to Issuers"
2. Help Needed to Survey
Health Plans Regarding Coverage of Midwifery Services
ACNM Submits Comments on
Marketplace "Letter to Issuers"
Earlier today, ACNM submitted comments
to the Centers for Medicare and Medicaid Services (CMS) in response to a draft
to Issuers" that the agency released for comment earlier this
month. The Letter, which is released on an annual basis, contains
policies that CMS intends to put into place for the following year affecting
the operation of health insurance plans offered through the Federally
At this point in time, the majority of states (36) allow the federal government
to operate a Marketplace on their behalf or in partnership with them. The
remaining states operate their own Marketplaces. As a result, the content
of this Letter will affect the majority of Marketplaces and may have spillover
effect to the extent that states adopt its policies. For information on
which course your state took, click here.
In the Letter, CMS proposes to make changes in the way the adequacy of plans'
provider networks are evaluated. For 2014, plan networks were evaluated
by existing mechanisms used by states, or by an accrediting agency.
For 2015, CMS has proposed that the agency would be solely responsible for
evaluating plan network adequacy and all plans operating through the Federally
Facilitated Marketplace would be required to submit information on their
provider networks to CMS for evaluation.
ACNM supports the centralization of this review, as we believe it will result
in a more consistent approach and will certainly make it simpler to advocate on
this topic, given the need to interact with only a single entity.
CMS further proposed the creation of a search engine function for consumers to
search for particular providers and provider types. ACNM supported this
proposal as well.
Finally ACNM informed CMS that we intend to conduct a survey of plans' coverage
of midwifery services that will allow us to provide them with concrete
information about this important coverage.
2. Help Needed to Survey Health Plans Regarding
Coverage of Midwifery Services
Related to the previous topic, ACNM is conducting a survey of health plans operating
in the Health Insurance Marketplaces to gather data on their
coverage of midwifery services, birth centers and home birth. We will
also be asking about their reimbursement rates vs. physicians and how they
list midwives in their plan network directories.
This information will be critical to our ability to advocate on this
issue, both with the regulators and also to convince plans that are outliers to
ensure adequate coverage of midwifery services.
There are 277 plans that must be contacted. There is only one
ACNM Director of Advocacy and Government Affairs. So, I need some
If you would be willing to make some calls to plans on ACNM's behalf,
please contact me to let me know.
I can be contacted at [email protected]