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ACNM Policy Update - 4/19/2016

Federal Issues

1. Midwife Attended Births in Every State, 1990 - 2014
2. Supreme Court Moves Closer to Compromise on Coverage of Contraception
3. AHRQ Releases Chartbook on Healthcare for Blacks
4. HRSA Opens up for NHSC New Site Applications
5. CMS Provides Information to States to Facilitate Coverage of LARC

State Issues

1. Reminder about ACNM State Policy Reporting
2. New State Laws – ID, AL


Federal Issues

1. Midwife Attended Births in Every State, 1990 – 2014

ACNM has updated a set of slides that use birth certificate data to track the percent of midwife attended births in the US and in each of the 50 states and DC from 1990 to 2014. Birth certificate data is known to have some inaccuracies associated with the listed attendant at birth, but it is the best data set available.

Overall, CNM/CM attended births rose from 8.17% in 2013 to 8.33% in 2014. Fourteen states saw a decrease in their rate, one remained stable and the remainder saw an increase.

2. Supreme Court Moves Closer to Compromise on Coverage of Contraception

The Supreme Court recently took the unusual step of asking the two sides in the Zubik v. Burwell case to submit proposals for a compromise to their disagreement. In this case, religious organizations object to an administrative requirement that they notify the government of their objection to providing contraceptive coverage so that the insurer through which they offer coverage can make alternative arrangements for such coverage for their employees. Plaintiffs maintain that the requirement makes them complicit in violating their own religious convictions.

In response to this request, the two parties submitted briefs and it appears that a compromise solution may be available. It is supposed that the Court took this action because the death of Justice Scalia made it more likely that a tie would occur in their decision, leaving the lower court decisions to stand. A decision in the case is expected this summer.

3. AHRQ Releases Chartbook on Healthcare for Blacks

The Agency for Healthcare Research and Quality (AHRQ) has released an updated version of its “Chartbook for Healthcare for Blacks.” The document contains a chapter specific to infant mortality and maternal care that tracks health disparities over a series of years.

4. HRSA Opens Up for NHSC New Site Applications

The Health Resources and Services Administration (HRSA) is now accepting applications from clinical sites wishing to participate in the National Health Service Corps (NHSC).

Benefits of becoming such a site include receiving assistance with recruiting and retaining qualified primary care providers and access to the NHSC Jobs Center, networking with similar organizations and direct access to state primary care officers to help increase access to primary health care services in your community.

To qualify, your clinical site must be located in a Health Professionals Shortage Area (HPSA), provide primary care regardless of a patient’s ability to pay, offer discounted fees to patients who qualify and accept Medicare, Medicaid and CHIP.

The application cycle is open through June 7, 2016 at 11:59 p.m. ET. For more detail, see HRSA’s 2016 Site Reference Guide.

5. CMS Provides Information to States to Facilitate Coverage of LARC

The Centers for Medicare and Medicaid Services (CMS) has issued aninformational bulletinto states providing recommendations and details on how state Medicaid programs can facilitate coverage of long acting reversible contraceptives (LARC), including such items as IUDs or implantable contraceptives. The document encourages states to provide timely coverage for provision of the contraception, raise payment rates to ensure providers offer the full range of contraceptive methods, reimburse for immediate postpartum insertion of LARC by unbundling payment for LARC from other labor and delivery services, and remove logistic and administrative barriers for supply management for LARC devices (e.g., allowing billing for office visits and LARC procedures on the same day or removing prior authorization requirements). The document provides a table with examples from states that have taken specific action to reduce barriers to LARC.


State Issues

1. Reminder about ACNM State Policy Reporting

Due to the volume of bills tracked by ACNM at the state level, in most instances reporting of legislative actions is restricted to enactments or gubernatorial vetoes. For up-to-date information on legislation ACNM is tracking in your state, visit the state legislative tracking system under the Advocacy tab on ACNM’s website. Please direct any questions regarding ACNM’s state policy activities to Cara Kinzelman at[email protected].

2. New State Laws – ID, AL

Idaho H.482 is intended to reduce the exposure of Idaho’s regulatory boards, commissions, and members to federal anti-trust prosecution by the modernization of applicable statutes. The bill allows the Governor to consider all qualified candidates recommended by trade associations and individuals for appointment to boards and commissions; clarifies that all members serve at the pleasure of the Governor; and requires that each board or commission have at least one consumer member. The bill was signed into law on April 5.


Idaho 
S. 1404 is the Unborn Infants Dignity Act, which “prohibits the sale, transfer, or distribution of the bodily remains of an aborted infant” and prohibits the use of such remains for experimentation or medical research. The bill was signed into law on April 5. A substantially similar bill, Alabama H.45, was signed into law on April 11.


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