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ACNM Policy Update - 4/28/2014

1.  How has the Physician Certification Requirement Affected You?
2.  Having Fun with GAC and PAC 
3.  HRSA Announces Funding Opportunity for Project to Improve Maternal Health and Safety 



1. How has the Physician Certification Requirement Affected You?

As most of you are aware, for Medicare discharges as of October 1, 2013, the Centers for Medicare and Medicaid Services (CMS) began enforcing a requirement that all inpatient admissions be certified as medically necessary by a physician.  The agency drew a distinction between the physician certification and an admission order, which, depending on state law and hospital bylaws, can be signed by a CNM (note that Medicare does not yet recognize CMs as a provider type that can independently bill Medicare). 

We have heard reports of hospitals responding to this situation by requiring that physicians certify admissions for all patients, regardless of whether they are Medicare beneficiaries.  Clearly, this creates a problem for midwives who have been admitting patients on their own as they would be required to obtain the physician's certification to validate their own admission order.

ACNM staff met with CMS to discuss the issue and were informed that changing the policy would require a change to the Medicare law. 

With the nurse practitioner organization ACNM met with congressional staff in both the House and Senate to discuss the potential of a statutory change.  During those meetings, congressional staff indicated that it would be very helpful for them to have specific stories about how this requirement had created barriers to care.

So, I am sending a broad solicitation to all of you.  If, as a result of the physician certification requirement, you have had trouble providing care to the women you serve I need to know about it.  Please send me specific details/stories that I can pass on to the congressional staff.


2.  Having Fun with GAC and PAC


Ok, so clearly I have been reading too much Dr. Seuss to my six year old, but....

The Government Affairs Committee (GAC) and the Midwives Political Action Committee (PAC) are both currently open to new volunteer participants.

Specifically, both Committees are seeking three student representatives for a minimum one-year term starting at the 2014 ACNM Meeting.  Attendance at the meeting is strongly preferred as it will give you a chance to connect with other Committee members.

Applicants (who must be ACNM members) don't need prior legislative or policy experience.  It's a great way to learn about the legislative process, work collaboratively with other midwives and student midwives, advance midwifery and have some fun in the process.  A more detailed description of the volunteer position is posted on ACNM's website.

If you're interested, please send a note indicating your interest, and a resume to [email protected]


3.  HRSA Announces Funding Opportunity for Project to Improve Maternal Health and Safety


The Health Resources and Services Administration (HRSA) has announced a funding opportunity for the Alliance on Maternal Health:  Improving Maternal Health and Safety.  The goal of the initiative is to reduce maternal morbidity and mortality and their associated adverse pregnancy outcomes (preterm birth, low birth weight and infant mortality) through efforts to engage provider organizations, state public health leaders, payers, hospital associations, regulatory bodies, consumer groups and other key organizations.  The project will last over a four-year period. 

The opportunity is open through June 16, 2014.  Funding will be provided in the form of a cooperative agreement as opposed to a grant.  This means that there would be substantial involvement between HRSA and the recipient during performance of the project.  Eligible applicants include any public or private entity. 


Should you have questions about federal issues, please contact Jesse Bushman, ACNM’s Director of Advocacy and Government Affairs at [email protected] or 240-485-1843.

Should you have questions about state issues, please contact Cara Kinzelman, ACNM’s Manager of State Government Affairs at [email protected] or 240-485-1841.  



Don’t forget to register for the ACNM 59th Annual Meeting & Exposition.  Details are available at the conference website. The deadline for the advance registration discount is May 7.  

Want to take action or get involved?  Contact ACNM's Government Affairs Committee.

Don't have the time or energy to get involved, but still want to contribute?  Support the Midwives-PAC.

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