Maternal Health Bill
On August 15th, 2024 the Massachusetts Legislature passed H.4999, An Act promoting access to midwifery care and out-of-hospital birth options which is now pending before the Governor for her signature. The Governor has 10 calendar days (from the bill’s passage) to sign the legislation. If she does not sign the bill within 10 days, it automatically becomes law.
This legislation takes a comprehensive approach to improving maternal health across the Commonwealth through the creation and expansion of birthing infrastructure, services and maternal health resources for residents in Massachusetts. I am proud to have voted for this bill in the House and am pleased that it is now on Governor Healey’s desk and she is expected to sign it into law.
While our state has an exemplary health care system that ranks among the best in the world, this bill includes important reforms that will address the systemic maternal health inequities which are detrimental to so many of our residents. This includes racial inequities that have long impacted pregnant patients of color, particularly members of the Black community. By creating solutions in response to the Special Commission on Racial Inequities in Maternal Health’s call of action, H.4999 will help to confront the maternal health crisis, improve birthing outcomes, and save lives for birthing families of all backgrounds in Massachusetts.
This bill was one of the bills that has been reported on as “failing” when it did not pass by July 31st. As I have previously reported, bills can still become law this term until the term ends on December 31, 2024. Here is a description of informal sessions.
This legislation takes significant steps to ensure better maternal health in the Commonwealth through several actions. Components of the bill include:
Midwifery Licensing and Coverage: Creates a state license that all professional midwives must receive in order to practice and requires certain insurance providers, such as MassHealth, to cover doula and midwifery services, as well as establishes the Board of Registration in Midwifery within the Department of Public Health (DPH) to license, provide oversight of licensed certified professional midwives, and promulgate regulations regarding the coordination of emergency care and the issuance of prescriptions for certain drugs by licensed certified professional midwives. The bill also requires that certified nurse-midwives receive payment rates equal to those for the same services performed by a physician under MassHealth.
Birth Centers: Encourages the creation of more freestanding birth centers, which operate independent from hospital systems, and requires DPH to promulgate updated regulations governing the licensure of freestanding birth centers to ensure safe, equitable, and accessible birth options.
Perinatal Screening: Requires that MassHealth cover noninvasive prenatal screenings to detect whether a pregnancy is at increased risk for chromosomal abnormalities for all pregnant patients regardless of age, baseline risk, or family history.
Maternal Mental Health: Establishes a grant program under the Executive Office of Health and Human Services aimed at addressing maternal mental health, which will support the establishment or expansion of initiatives serving perinatal individuals, particularly those in underserved populations, to improve mental health, behavioral health, and substance use disorder. This legislation also mandates that insurers provide coverage for postpartum depression and major depressive disorder screenings for perinatal individuals.
Mortality Research and Prevention: Ensures that the Maternal Mortality and Morbidity Review Committee will have access to essential records required to conduct thorough and timely reviews of maternal deaths and pregnancy complications. This will enable the Committee to formulate comprehensive recommendations to improve maternal outcomes and prevent mortality. It also requires DPH to establish a program to conduct fetal and infant mortality reviews (FIMR) to identify social, economic, and systems level factors associated with fetal and infant deaths and inform public health policy programs.
Maternal Health Task-Force and Awareness: Requires DPH to disseminate information about pregnancy loss to the public, and perinatal health care workers as to prioritize the physical and mental health care of patients affected. The bill also establishes a nine-member task force to study the accessibility to maternal health services and care, as well as closures of inpatient maternity units and acute-level birthing centers. The task force will identify methods of increasing financial investment in, and patient access to, maternal health care in the Commonwealth. Additionally, the bill includes a provision that will allow Massachusetts residents to use earned paid sick time in the event of a pregnancy loss.
Milk Product and Lactation Services Coverage: Requires health insurers to provide coverage for medically necessary pasteurized donor human milk and products derived from it, serving as a critical source of nutrition for the growth and development of babies, particularly for vulnerable premature infants. To better support new mothers in their feeding journeys, the bill also authorizes the Board of Allied Health Professionals to license lactation consultants to ensure their services are eligible for reimbursement through the patient’s insurance.
Maternal health care is essential to the future prosperity of the Commonwealth. Our individual residents cannot thrive and our communities cannot flourish without quality medical services for pregnant patients. I am proud to have voted in favor of this critical legislation, and I look forward to it being signed into law in the coming days. As always, please do not hesitate to contact my office if you have any questions or concerns.
Best Regards,
Jay