Code of the District of Columbia

Subchapter VI-F. Medicaid Reimbursement for Certified Professional MIdwives.


§ 3–1206.71. Reimbursement for certified professional midwives.

(a) A health benefit plan or health insurance provided through Medicaid shall provide coverage for services rendered by a certified professional midwife for services within the scope of the practice of certified professional midwifery, regardless of the location where such services are provided.

(b) Coverage for services provided by a certified professional midwife shall not be subject to any greater copayment, deductible, or coinsurance than is applicable to any other similar benefits provided by the health benefit plan or health insurance coverage provided through Medicaid.

(c) A health benefit plan may require that maternity services be provided by a certified professional midwife under contract with the health benefit plan.

(d)(1) For the purposes of this section, the term "health benefit plan" means any accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfare arrangement, or plan provided by another benefit arrangement.

(2) The term "health benefit plan" does not include:

(A) Accident-only coverage, credit, or disability insurance;

(B) Coverage of Medicare services or federal employee health plans, pursuant to contracts with the United States government;

(C) Medicare supplement or long-term care insurance;

(D) Dental only or vision only insurance;

(E) Specified-disease insurance;

(F) Hospital confinement indemnity coverage;

(G) Limited benefit health coverage;

(H) Coverage issued as a supplement to liability insurance;

(I) Insurance arising out of a workers' compensation or similar law;

(J) Automobile medical payment insurance;

(K) Medical expense and loss of income benefits; or

(L) Insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.


(Mar. 25, 1986, D.C. Law 6-99, § 671; as added June 17, 2020, D.C. Law 23-97, § 2(e), 67 DCR 3912.)

Applicability

Section 7078 of D.C. Law 23-149 repealed section 6 of D.C. Law 23-97 removing the applicability provision impacting this section. Therefore, the creation of this section by Law 23-97 has been implemented.

Applicability of D.C. Law 23-97: § 6 of D.C. Law 23-97 provided that the creation of this section by § 2(e) of D.C. Law 23-97 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Editor's Notes

Section 5 of D.C. Law 23-97 provided that the Mayor, pursuant to Chapter 5 of Title 2, shall issue rules to implement the provisions of D.C. Law 23-97.