Amendment #8 to H4773

Equitable Reimbursement for Certified Nurse Midwives

Ms. Fluker Oakley of Boston moves to amend the bill by adding the following section:

SECTION  XXXX. Chapter 32A of the General Laws is hereby amended by adding the following section:-

Section 31. The commission shall provide to any active or retired employee of the commonwealth insured under the group insurance commission coverage for services rendered by a certified nurse midwife designated to engage in the practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C of chapter 112; provided, however, that the following conditions are met: (1) the service rendered is within the scope of the certified nurse midwife’s authorization to practice by the board of registration in nursing; (2) the policy or contract currently provides benefits for identical services rendered by a health care provider licensed by the commonwealth; and (3) the reimbursement for the services provided shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician to achieve compliance with this section.

SECTION XXXX. Chapter 118E of the General Laws is hereby amended by adding the following section:-

Section 80. The division shall provide coverage for services rendered by a certified nurse midwife designated to engage in the practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C of chapter 112; provided, however, that the following conditions are met: (1) the service rendered is within the scope of the certified nurse midwife’s authorization to practice by the board of registration in nursing; (2) the policy or contract currently provides benefits for identical services rendered by a health care provider licensed by the commonwealth; and (3) the reimbursement for the services provided shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician to achieve compliance with this section.

SECTION XXXX. Section 47E of Chapter 175 of the General Laws, as appearing in the 2018 Official Edition, is hereby amended by adding the following sentences:- The reimbursement for the services provided pursuant to this section shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

SECTION XXXX. Chapter 176A of the General Laws is hereby amended by inserting after section 8OO the following section:-

Section 8PP. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed in the commonwealth shall provide as a benefit to all individual subscribers and members within the commonwealth and to all group members having a principal place of employment within the commonwealth for services rendered by a certified nurse midwife designated to engage in the practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C of chapter 112; provided, however, that the following conditions are met: (1) the service rendered is within the scope of the certified nurse midwife’s authorization to practice by the board of registration in nursing; (2) the policy or contract currently provides benefits for identical services rendered by a health care provider licensed by the commonwealth; and (3) the reimbursement for the services provided shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

SECTION XXXX. Section 4G of Chapter 176B of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by adding the following sentences:- The reimbursement for the services provided pursuant to this section shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

SECTION XXXX. Section 4 of Chapter 176G of the General Laws, as so appearing, is hereby amended by adding the following subsection:-

(g) services rendered by a certified nurse midwife designated to engage in the practice of nurse-midwifery by the board of registration in nursing pursuant to section 80C of chapter 112, subject to the terms of a negotiated agreement between the health maintenance organization and the provider of health care services. The reimbursement for the services provided shall be in the same amount as the reimbursement paid under the policy to a licensed physician performing the service in the area served. An insurer may not reduce the reimbursement paid to a licensed physician in order to comply with this section.

Additional co-sponsor(s) added to Amendment #8, as changed to H4773

Equitable Reimbursement for Certified Nurse Midwives