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ACNM Policy Update - 6/11/2014


1.  ACNM Submits Comments on Provider Non-Discrimination

2.  ACNM and National Women's Law Center to Host Webinar on Contraceptive and Breastfeeding Coverage Under the ACA

3.  Does Medicaid Reimburse You for Vaccinations for Pregnant Women?

4.  FDA Finalizes Regulation Implementing Good Manufacturing Practices for Infant Formula Manufacturers


1.  ACNM Submits Comments on Provider Non-Discrimination

On June 10, ACNM submitted comments in response to a Request for Information from the Centers for Medicare and Medicaid Services (CMS) regarding how the provider non-discrimination provisions of the Affordable Care Act (ACA) should be implemented.  In our comments ACNM emphasized the need to include in plan networks all providers who are licensed to perform services that the plan must provide pursuant to provisions of the essential health benefits requirements or because of state or federal insurance mandates. 

We also identified three specific problems with an FAQ previously released by the Departments of Health and Human Services, Treasury and Labor that offered interpretations of the non-discrimination language of the Public Health Service Act that do not appear to be supported by the statutory language.

ACNM's comments also reported on the results of a survey of health plans that we undertook to more fully understand how plans are covering the services of midwives.  Those working on the survey attempted to contact 277 plans and were able to survey 69.  An analysis of the survey responses shows that:

  • 14.3% of plans do not contract with CNMs to include them in the plan’s provider network.  
  • 12.1% of plans that contract with CNMs do not cover primary care services provided by CNMs.   
  • 22.4% of plans contracting with CNMs will not cover their services when provided in a birth center.
  • 36.0% of plans contracting with CNMs will not cover home birth services provided by CNMs.
  • 35.1% of plans contracting with CNMs pay them at a lower rate than they pay physicians.  
  • 8.8% of plans contracting with CNMs do not list them in their provider directories.
  • 39.7% of plans do not contract with birth centers.

(Note that we were only able to survey a very small number of plans in states that license CMs so have not reported on those data here).

 

2.  ACNM and National Women's Law Center to Host Webinar on Contraceptive and Breastfeeding Coverage Under the ACA

On June 25, ACNM and the National Women's Law Center (NWLC) will host a joint webinar to discuss the coverage requirements for birth control and breastfeeding support and supplies under the Affordable Care Act (ACA). 

This webinar will give CNMs/CMs an in-depth understanding of the ACA’s birth control coverage requirement and the breastfeeding support, supplies, and counseling coverage requirement.  Attendees will learn about the practical implications of these coverage requirements on their patients and practices.  The NWLC will provide attendees with tools to help their patients who are not getting the coverage required by the health care law.

  • Date: Wednesday, June 25, 2014
  • Time: 1:00-2:00 p.m. Eastern
  • Presenters:  Sharon Levin, Director of Federal Reproductive Health Policy, NWLC; Anna Benyo, Senior Policy Analyst, NWLC; and Jesse Bushman, Director of Advocacy and Government Affairs, ACNM.

Register today to join us for an informative discussion.  

 

3.  Does Medicaid Reimburse You for Vaccinations for Pregnant Women?

ACNM is cooperating with ACOG, the March of Dimes and the American Academy of Pediatricians to address a concern that has come to our attention regarding Medicaid reimbursement for vaccinations provided to pregnant women.  Many states provide pregnant women with coverage known as "pregnancy only" coverage, meaning that they only cover items and services deemed related to the pregnancy.  Apparently, a subset of states do not reimburse for Tdap or influenza vaccinations provided to pregnant women.  We do not believe that these vaccinations should be excluded from the set of pregnancy related services and are looking at ways in which we can address this issue both with the individual states and with the Federal government.

We need to know if you have ever administered a Tdap or influenza vaccination to a woman covered under Medicaid and have not been reimbursed.  Please send specific details to Jesse Bushman at  [email protected].  

 

4.  FDA Finalizes Regulation Implementing Good Manufacturing Practices for Infant Formula Manufacturers

On June 9, the Food and Drug Administration (FDA) announced that it is finalizing a rule, first published as an interim final rule on February 10, 2014, that sets standards for manufacturers of infant formula. A press release issued with the final rule acknowledges that "While breastfeeding is strongly recommended and many mothers hope to breastfeed their infants, most infants in the U.S. rely on infant formula for some portion of their nutrition."  The final regulation is designed to ensure that formula used by these infants is safe and bioavailable. 

Under the final rule, standards include:

  • Current good manufacturing practices specifically designed for infant formula, including required testing for the harmful pathogens (disease-causing bacteria) Salmonella and Cronobacter.
  • A requirement that manufacturers demonstrate that the infant formulas they produce support normal physical growth.
  • A requirement that infant formulas be tested for nutrient content in the final product stage, before entering the market, and at the end of the products’ shelf life. 



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


 

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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