I 
111TH CONGRESS 
1ST SESSION H. R. 2358 
To amend title XIX of the Social Security Act to require coverage under 
the Medicaid Program for freestanding birth center services. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 12, 2009 
Mrs. DAVIS of California (for herself, Mr. BILIRAKIS, Mrs. CAPPS, and Mr. 
WITTMAN) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to require 
coverage under the Medicaid Program for freestanding 
birth center services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Medicaid Birth Center 
Reimbursement Act’’. 
SEC. 2. COVERAGE UNDER MEDICAID FOR FREESTANDING 
BIRTH CENTER SERVICES. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
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(1) in subsection (a)— 
(A) by redesignating paragraph (28) as 
paragraph (29); 
(B) in paragraph (27), by striking at the 
end ‘‘and’’; and 
(C) by inserting after paragraph (27) the 
following new paragraph: 
‘‘(28) freestanding birth center services (as de-
fined in subsection (l)(3)(A)) and other ambulatory 
services that are offered by a freestanding birth cen-
ter (as defined in subsection (l)(3)(B)) and that are 
otherwise included in the plan; and’’; and 
(2) in subsection (l), by adding at the end the 
following new paragraph: 
‘‘(3)(A) The term ‘freestanding birth center services’ 
means services furnished to an individual at a freestanding 
birth center (as defined in subparagraph (B)), including 
by a licensed birth attendant (as defined in subparagraph 
(C)) at such center. 
‘‘(B) The term ‘freestanding birth center’ means a 
health facility— 
‘‘(i) that is not a hospital; and 
‘‘(ii) where childbirth is planned to occur away 
from the pregnant woman’s residence. 
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‘‘(C) The term ‘licensed birth attendant’ means an 
individual who is licensed or registered by the State in-
volved to provide health care at childbirth and who pro-
vides such care within the scope of practice under which 
the individual is legally authorized to perform such care 
under State law (or the State regulatory mechanism pro-
vided by State law), regardless of whether the individual 
is under the supervision of, or associated with, a physician 
or other health care provider. Nothing in this subpara-
graph shall be construed as changing State law require-
ments applicable to a licensed birth attendant.’’. 
(b) 
CONFORMING
AMENDMENT.—Section 
1902(a)(10)(A) of the Social Security Act (42 U.S.C. 
1396a(a)(10)(A)) is amended by striking ‘‘and (21)’’ and 
inserting ‘‘, (21), and (28)’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section 
shall take effect 90 days after the date of the enact-
ment of this Act and shall apply to services fur-
nished on or after such date. 
(2) EXCEPTION
IF
STATE
LEGISLATION
RE-
QUIRED.—In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act 
which the Secretary of Health and Human Services 
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determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to 
meet the additional requirement imposed by the 
amendments made by this section, the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet this additional requirement before 
the first day of the first calendar quarter beginning 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
Æ 
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