HF 334 (LSB 2134YH (3) 90)

HOUSE FILE 334

BY  BERGAN

A BILL FOR

An Act relating to coverage for the CenteringPregnancy model of group prenatal care under the Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  MEDICAID GROUP PRENATAL CARE —— CENTERINGPREGNANCY MODEL.
   1.  The general assembly finds all of the following:
   a.  CenteringPregnancy is an evidence-based model of group prenatal care that has been shown to improve birth outcomes for both mothers and babies.
   b.  Research indicates that the benefits of CenteringPregnancy include increased birth weights, increased rates of breastfeeding, reduced risk of pre-term pregnancies, and reduced risk of gestational diabetes.
   c.  Across studies, CenteringPregnancy reduces the odds of premature birth, the single largest contributor to infant mortality, by between thirty-three and forty-seven percent.
   d.  CenteringPregnancy provides even greater benefits to certain high-risk populations and can be effective at reducing health disparities related to race, ethnicity, and socioeconomic status.
   e.  By reducing the rate of negative birth outcomes, CenteringPregnancy prevents high-cost medical interventions and reduces overall costs of care.
   f.  Expanding patient access to CenteringPregnancy within Iowa’s Medicaid program will simultaneously improve population health outcomes and reduce overall costs of health care delivery.
   2.  The department of health and human services shall submit any state plan amendment or waiver to the centers for Medicare and Medicaid services of the United States department of health and human services as necessary for approval to include group prenatal care based on the CenteringPregnancy model as a covered service under the Medicaid program.
   3.  Expenses of a provider for group prenatal care shall be reimbursed provided that all of the following criteria are met:
   a.  The provider, including but not limited to a federally qualified health center or a community health center, is a site accredited by the centering healthcare institute or is a site engaged in an active implementation contract with the centering healthcare institute, that utilizes the CenteringPregnancy model.
   b.  The provider incorporates the applicable information outlined in any best practices manual for prenatal and postpartum maternal care developed by the department of health and human services into the curriculum for each group prenatal visit.
   c.  The provider ensures that each group prenatal care visit is at least one and one-half hours in duration with a minimum of two women and a maximum of twenty women participating.
   d.  The provider provides that no more than ten group prenatal care visits occur per pregnancy.
   4.  As used in this section, “group prenatal care services” means a series of prenatal care visits provided in a group setting which are based upon the CenteringPregnancy model developed by the centering healthcare institute and which include health assessments, social and clinical support, and educational activities.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill requires the department of health and human services (HHS) to receive federal approval to include group prenatal care based on the CenteringPregnancy model as a covered service under the Medicaid program. Reimbursement is contingent upon the provider of group prenatal care, including but not limited to a federally qualified health center or a community health center, being a site accredited by the centering healthcare institute or a site engaged in an active implementation contract with the centering healthcare institute, that utilizes the CenteringPregnancy model; incorporating the applicable information outlined in any best practices manual for prenatal and postpartum maternal care developed by HHS into the curriculum for each group prenatal visit; ensuring that each group prenatal care visit is at least 1.5 hours in duration with a minimum of two women and a maximum of 20 women participating; and providing that no more than 10 group prenatal care visits occur per pregnancy. The bill defines “group prenatal care services” as a series of prenatal care visits provided in a group setting which are based upon the CenteringPregnancy model developed by the centering healthcare institute and which include health assessments, social and clinical support, and educational activities.