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ACNM Policy Update - 5/15/2015

State Issues

1.  Selected State Developments – Introductions and Progress - AL, DE, HI, OH, TN
2.  Selected State Developments – New Laws - IN, KY, MD, NE, OR

Federal Issues

1.  Where is the Best Place to be a Midwife?
2.  CMS Releases Guidance on Coverage of Contraceptive Items and Services
3.  Kaiser Family Foundation Releases Report on "Medicaid at 50"
  

State Issues

Note:  Current status of state legislation of interest to ACNM members can be obtained through ACNM's Legislative Tracking Tool.  We strongly encourage affiliate legislative chairs to regularly check this site to see the status of legislation in their states.
 
1.  Selected State Developments – Introductions and Progress - AL, DE, HI, OH, TN
 
Alabama S.234 would increase the number of advanced practice nurses on the Board of Nursing, among other things. The bill has passed the Senate.
Delaware H.70, which modernizes the practice act for CPMs and CMs by removing the requirement for a written collaborative agreement, among other things, has passed the Senate unanimously and is bound for the Governor’s desk.
 
Hawaii H.782 would require the Department of Health to establish a public education program to inform and educate women about cytomegalovirus. The bill has been transmitted to the Governor.

Ohio S.110, which concerns an APRNs ability to delegate the authority to administer a drug, among other things, has passed the Senate.

Tennessee S.44
 proposes to require that every newborn be tested for lysosomal storage disorders, including Krabbe, Fabry, Gaucher, Pompe, Hurler Syndrome, Niemann-Pick, and others as determined by the Department of Health. The bill has been transmitted to the Governor for consideration.
 

2.  Selected State Developments – New Laws - IN, KY, MD, NE, OR
 
Indiana H.1004 requires the Department of Health to establish and manage the PIN (Protecting Indiana’s Newborns) Grant program for the purpose of reducing Indiana’s infant mortality rates. The bill was signed by the Governor on May 4.
 
Indiana H.1093 requires the Department of Health to collect certain information to be disseminated by health care facilities and health care providers to parents who receive prenatal test results for Down syndrome or any other condition diagnosed prenatally. The bill became law on April 27.
 
Kentucky S.54 mandates that substance abuse treatment or recovery service providers which receive state funding shall give pregnant women priority in accessing their services. It further states that a petition may not be filed to terminate the parental rights of a woman solely because of her use of a non-prescribed controlled substance during pregnancy if she enrolls in and maintains substantial compliance with both a substance abuse treatment or recovery program and a regimen of prenatal care throughout the remaining term of her pregnancy. The bill was signed by the Governor on March 30.
 
Maryland H.9 provides for the licensure of CPMs. The Maryland ACNM affiliate was actively involved in stakeholder negotiations to help craft language that is compliant with US MERA agreements and could therefore be wholeheartedly supported by ACNM. The Governor signed the bill into law on May 12.
 
Nebraska L.264 specifies that, beginning December 2015, the education, training, or service completed by an applicant for a credential while a member of the armed forces of the United States, active or reserve, the National Guard of any state, the military reserves of any state, or the naval militia of any state shall be accepted toward the minimal standards for professional credentials necessary for licensure, including certified nurse-midwifery.  The bill was approved by the Governor on May 13.
 
Oregon H.2390A, grants admitting privileges and medical staff voting rights to CNMs approved to practice in a hospital, passed the Senate unanimously last week. The Governor signed the bill into law on May 12.
 
Oregon H. 2468, requires insurers to maintain an adequate number and range of provider types in their provider networks and prohibits them from discriminating against providers who are acting within their scope of practice.  The Governor signed the bill into law on May 12.
 
 
Federal Issues

1.  Where is the Best Place to be a Midwife?

ACNM has posted an updated version of a previously released set of slides that outline variations among states in factors that impact the environment for midwifery practice.  Included in the slides are numerous state-by-state data sets on topics such as midwifery demographics, birth demographics, practice patterns, reimbursement and compensation. 

This slide deck would be an indispensable tool for any individual who is choosing where she/he wants to practice and also contains data that could be used for business operations or salary negotiation as well.

Please feel free to contact me with any feedback and/or suggestions.
 

2.  CMS Releases Guidance on Coverage of Contraceptive Items and Services
 
In response to studies showing that insurers are inappropriately denying or curtailing coverage for contraceptive items and services, the Centers for Medicare and Medicaid Services (CMS) has released guidance providing clarification to several questions on this topic. 
 
Notably, CMS requires insurers to cover, without cost sharing, at least one form of contraception in each of the 18 categories currently identified by the FDA in its guidance on birth control.  The revised guidance does allow for plans to impose reasonable medical management, such as requiring the use of generics when they are available, but includes a requirement that plans have exceptions processes for such situations.


3.  Kaiser Family Foundation Releases Report on "Medicaid at 50"

The Kaiser Family Foundation (KFF) has released a report entitled "Medicaid at 50," providing an overview of the program since it's inception in 1965.  It contains a good description of how the program has grown into the most important payer in the country with regard to pregnant women.

 
Please share this Policy Update with any CNMs/CMs you know who are not ACNM members.  We want them to know what the association is doing to help them out and encourage them to become a part of the association.


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.  

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



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American College of Nurse-Midwives.
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