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S 3045

An Act promoting and enhancing the sustainability of birth centers and the midwifery workforce

194th Legislature (2025-2026) Introduced by Mike Brady and 20 co-sponsors

The bill ensures pay parity for midwives with physicians across public and private plans and creates licensing guidance to expand safe birth center access.

Referred to the committee on Senate Ways and Means
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Bill Summary · S 3045

Summary of Bill S.3045 (194th Massachusetts General Court)

Purpose and intent

  • To promote and enhance the sustainability of birth centers and the midwifery workforce in Massachusetts.
  • Aims to establish parity in payment for midwifery services with physician services across public, private, and state-regulated insurance and health plan contracts.
  • Includes a mechanism for state licensing and guidance specific to birth centers to support safe, low-risk childbirth options.

Key provisions and changes

1) Payment parity for midwifery services (public sector)
- Section 17X (Chapter 32A):
- For active or retired Commonwealth employees insured under group plans:
- Payment for services by a certified nurse-midwife (CNM) within their authorized scope must be no less than the rate for the same service when performed by a physician.
- Payment for services by a licensed certified professional midwife (CPM) within their scope must be no less than the physician rate, regardless of service site or length of stay.

2) Expanded coverage clarity for Medicaid managed care and related contracts
- Section 2 and 3 (Chapter 118E):
- Extends coverage obligations to include the division and its contracted entities (health insurers, plans, HMOs, BH management firms, and third-party admins) under Medicaid managed care, accountable care organizations, and primary care clinician plans.
- Requires coverage for midwifery services (prenatal, childbirth, postpartum) by CPMs/CNMs, with no less favorable payment rates than physician services, regardless of site or stay length.

3) Private health insurance parity (provisions across multiple chapters)
- Section 4 (Chapter 175), Section 5 (Chapter 176A), Section 6 (Chapter 176B), Section 7 (Chapter 176G):
- Requires insurers and health plans (including individual/group hospital service plans and health maintenance contracts) to pay CNMs and CPMs at rates no less than physician rates for the same services (prenatal through postpartum care), regardless of where services are provided.

4) Birth center-specific licensing and guidance
- Section 8:
- Within 12 months after enactment, the Department of Public Health must establish licensing requirements, plan review checklists, and facility guidelines specifically for birth centers and low-risk birth settings.
- Development should involve collaboration with birth center operators, prospective birth center developers, midwifery and birth center advocacy groups (e.g., American College of Nurse-MMidwives, National Association of Certified Professional Midwives, American Association of Birth Centers, Commission for the Accreditation of Birth Centers), and other related stakeholders.

Affected parties and potential impact

  • Midwives:
    • CNMs and CPMs would receive guaranteed parity in reimbursement with physicians for covered services, improving financial viability and sustainability of midwifery practice.
  • Patients and pregnant people:
    • Greater access to midwifery-led prenatal, birth, and postpartum care with predictable, physician-rate reimbursement, potentially expanding options for low-risk births at birth centers or other settings.
  • Employers and state programs:
    • State employee health plans and Medicaid-related contracts would implement parity requirements, potentially affecting premium and plan design considerations.
  • Birth centers:
    • Long-term guidance, licensing standards, and facility guidelines aim to create a clearer regulatory framework, improving startup viability and ongoing operations.

Timeline and procedural notes

  • The act requires the Department of Public Health to complete birth center licensing and facility guidelines within 12 months of the act’s effective date.
  • The bill was reported favorably by the Senate Committee on Health Care Financing and referred to Senate Ways and Means, indicating fiscal considerations (estimated cost greater than $100,000) and ongoing legislative action.

Overall takeaway

S.3045 seeks to:
- Achieve pay parity between midwives and physicians for covered services.
- Ensure comprehensive coverage of midwifery services by public and private payers, including Medicaid managed care entities.
- Establish birth-center-specific regulatory guidance and licensing to support widespread, safe access to midwifery-led birth options.
- Promote the sustainability and growth of the midwifery workforce and birth centers in Massachusetts.

Compiled from official sources — confirm details with the bill’s official record.

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