II 

111TH CONGRESS 

1ST SESSION S. 1423 

To amend title XIX of the Social Security Act to require coverage under 

the Medicaid Program for freestanding birth center services. 

IN THE SENATE OF THE UNITED STATES 

JULY 9, 2009 

Mrs. BOXER (for herself and Mr. BEGICH) introduced the following bill; which 

was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to require 

coverage under the Medicaid Program for freestanding 

birth center services. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Medicaid Birth Center 

5 Reimbursement Act’’. 

6 SEC. 2. COVERAGE UNDER MEDICAID FOR FREESTANDING 

7 BIRTH CENTER SERVICES. 

8 (a) IN GENERAL.—Section 1905 of the Social Secu9 rity Act (42 U.S.C. 1396d) is amended— 

10 (1) in subsection (a)— 


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1 (A) by redesignating paragraph (28) as 

2 paragraph (29); 

3 (B) in paragraph (27), by striking at the 

4 end ‘‘and’’; and 

5 (C) by inserting after paragraph (27) the 

6 following new paragraph: 

7 ‘‘(28) freestanding birth center services (as de8 fined in subsection (l)(3)(A)) and other ambulatory 

9 services that are offered by a freestanding birth cen10 ter (as defined in subsection (l)(3)(B)) and that are 

11 otherwise included in the plan; and’’; and 

12 (2) in subsection (l), by adding at the end the 

13 following new paragraph: 

14 ‘‘(3)(A) The term ‘freestanding birth center services’ 

15 means services furnished to an individual at a freestanding 

16 birth center (as defined in subparagraph (B)), including 

17 by a licensed birth attendant (as defined in subparagraph 

18 (C)) at such center. 

19 ‘‘(B) The term ‘freestanding birth center’ means a 

20 health facility— 

21 ‘‘(i) that is not a hospital; and 

22 ‘‘(ii) where childbirth is planned to occur away 

23 from the pregnant woman’s residence. 

24 ‘‘(C) The term ‘licensed birth attendant’ means an 

25 individual who is licensed or registered by the State inVerDate Nov 24 2008 02:05 Jul 10, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1423.IS S1423

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1 volved to provide health care at childbirth and who pro2 vides such care within the scope of practice under which 

3 the individual is legally authorized to perform such care 

4 under State law (or the State regulatory mechanism pro5 vided by State law), regardless of whether the individual 

6 is under the supervision of, or associated with, a physician 

7 or other health care provider. Nothing in this subpara8 graph shall be construed as changing State law require9 ments applicable to a licensed birth attendant.’’. 

10 (b) CONFORMING AMENDMENT.—Section 

11 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 

12 1396a(a)(10)(A)) is amended by striking ‘‘and (21)’’ and 

13 inserting ‘‘, (21), and (28)’’. 

14 (c) EFFECTIVE DATE.— 

15 (1) IN GENERAL.—Except as provided in para16 graph (2), the amendments made by this section 

17 shall take effect 90 days after the date of the enact18 ment of this Act and shall apply to services fur19 nished on or after such date. 

20 (2) EXCEPTION IF STATE LEGISLATION RE21 QUIRED.—In the case of a State plan for medical as22 sistance under title XIX of the Social Security Act 

23 which the Secretary of Health and Human Services 

24 determines requires State legislation (other than leg25 islation appropriating funds) in order for the plan to 


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1 meet the additional requirement imposed by the 

2 amendments made by this section, the State plan 

3 shall not be regarded as failing to comply with the 

4 requirements of such title solely on the basis of its 

5 failure to meet this additional requirement before 

6 the first day of the first calendar quarter beginning 

7 after the close of the first regular session of the 

8 State legislature that begins after the date of the en9 actment of this Act. For purposes of the previous 

10 sentence, in the case of a State that has a 2-year 

11 legislative session, each year of such session shall be 

12 deemed to be a separate regular session of the State 

13 legislature. 

Æ 


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