Alternative birth centers: licensing and Medi-Cal reimbursement.

Plain English Breakdown

The official source does not provide specific details on the number of current alternative birth centers or their exact impact.

Rules for Birth Centers and Health Insurance

AB-55 changes the rules for licensing alternative birth centers and how they get paid by Medi-Cal, a health insurance program.

What This Bill Does

• Removes the requirement that alternative birth centers must provide comprehensive perinatal services as defined in Medi-Cal provisions.
• Requires alternative birth centers to have written policies for transferring patients to hospitals if needed.
• Specifies what information these transfer policies should include, such as arrangements for referral of complications, transfer of care, provision of medical records, estimated transfer time, and a clear explanation of the facility’s overall emergency transfer plan.

Who It Names or Affects

• Alternative birth centers
• Pregnant women using alternative birth centers
• State Department of Public Health
• Medi-Cal program

Terms To Know

alternative birth center

A clinic that is not part of a hospital and provides care for pregnant women during childbirth.

Medi-Cal

A health insurance program in California that helps low-income people pay for medical costs.

Limits and Unknowns

• The bill does not specify an effective date, so it is unclear when the changes will take effect.
• It's not clear how many alternative birth centers are currently affected by these rules.

Official Summary Text

AB 55, Bonta.
Alternative birth centers: licensing and Medi-Cal reimbursement.
Existing law provides for the licensure and regulation of various types of clinics, including alternative birth centers, by the State Department of Public Health, and makes a violation of those provisions a crime. Existing law defines an alternative birth center as a clinic that is not part of a hospital and that provides comprehensive perinatal services and delivery care to pregnant women who remain less than 24 hours at the facility. Existing law requires a licensed alternative birth center specialty clinic, and a licensed primary care clinic that provides services as an alternative birth center, to meet certain criteria, including, among others, being located in proximity to a facility with the capacity for management of obstetrical and neonatal emergencies, as specified.
Existing law establishes the Medi-Cal program, which is administered
by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law sets forth certain criteria for Medi-Cal reimbursement to alternative birth centers for facility-related delivery costs.
Under existing law, as a criterion under both the licensing provisions and the Medi-Cal reimbursement provisions described above, the facility is required to be a provider of comprehensive perinatal services as defined in the Medi-Cal provisions.
This bill would remove, under both sets of criteria, the certification condition of being a provider of comprehensive perinatal services as defined in the Medi-Cal provisions. The bill would require the facility to provide
perinatal services that are comprehensive in nature, as specified, consistent with certain standards. The bill would remove the above-described proximity requirement and would instead require a written policy for hospital transfer. The bill would require the policy to include certain requirements relating to, among other things, arrangements for the referral of a complication, arrangements for the transfer of care, provision of medical records, information about the estimated transfer time, and a clear explanation of the facility’s overall emergency transfer plan, as specified.
The bill would also make a technical change to an obsolete reference within a related provision.
By creating new requirements for an alternative birth center or a primary care clinic that provides services as an alternative birth center, the violation of which is a crime, the bill would impose a state-mandated local program.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

Current Bill Text

Download Bill PDF