Midwives on/off Medicaid

| September 30, 2004
When a group of Montana midwives decided last March that they would pursue Medicaid reimbursement for their services, one among them announced that she had already been receiving Medicaid reimbursement in Montana for the past three years.

“We were just shocked,” says Missoula midwife Dolly Browder.

She herself had applied for a Medicaid number, which facilitates reimbursement, 10 years ago. “They just shut me down right away,” says Browder. Her colleague, on the other hand, had moved from New Mexico, which does reimburse midwives, and had assumed that Montana did, too. And for her, Montana did—by accident.

Following her lead, about nine or 10 midwives applied, says Browder. All were approved. In early July, Browder received her Medicaid number, retroactive to November 2003.

This summer, when she saw her bank account swell slightly, she realized she had been reimbursed.

Then, as quickly as it began, the Medicaid party was over. In early September, Browder and the other midwives received letters from the Montana Department of Public Health and Human Services (MDPHHS) announcing that they would no longer be reimbursed by Medicaid and that they were expected, in fact, to reimburse Medicaid moneys already disbursed.

But late in the day on Sept. 28, Chuck Hunter, administrator of the child and adult health services division of MDPHHS, said that he believes MDPHHS will not expect reimbursement—between $8,000 and $10,000 in total—after all. The midwives, he says, provided services in good faith and shouldn’t be penalized.

Hunter does not believe that the department is considering reinstating the midwives’ Medicaid numbers, but he plans to do a bit more research into the option. “I’ll probably look into this a little deeper now that it’s on my radar screen,” he says.

The midwives still plan to pursue Medicaid reinstatement, says Browder. Home births typically cost a little under $2,000 she says, much less than hospital fees that average between $6,000 and $8,000. Because Medicaid clients do not have the option of the less expensive home births, Browder sees the situation as clear discrimination against people of lesser resources.

Add a comment