Description: The health care authority (HCA) intends to submit medicaid SPA 21-0032 in order to obtain medicaid funds to reimburse birthing hospitals to support the "rooming in" of the birth parent with their newborn following an in-utero exposure to substances that may lead to physiologic dependence, until the newborn is recovered from neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) and/or is otherwise ready to be medically discharged. The intent is to provide a newborn administrative day rate or daily reimbursement to help offset the cost of providing the postpartum parent with room and board and limited additional services that are centered on the care and well-being of the newborn.

This SPA reflects HCA's response to SSB 5380 which directed HCA to make recommendations on ways to improve the care of birth parents with opioid use disorder and their newborns. Substantial research indicates that keeping the birth parent with the newborn during the exposed newborn's period of observation and potential withdrawal of neonatal NAS/NOWS as the first-line, nonmedication treatment is associated with better outcomes for both the birth parent and the newborn.

Based on this evidence, HCA recommended that the state authorize HCA to provide funds for the first-line nonmedication treatment of newborns by reimbursing birthing hospitals to support the "rooming in" and continuous care from the birth parent for their newborn when there has been in-utero exposure to substances that may lead to physiologic dependence.

SPA 21-0032 is expected to have no effect on the annual aggregate payment for this service. HCA anticipates the increased payment for the administrative day to be offset by a reduction in the length of stay required for infants with NAS/NOWS. Studies published by the National Association of Neonatal Nurses report a reduction in hospital stay days ranging from 35-74 percent. HCA anticipates shorter stays with a higher payment creating a net effect of $0.

SPA 21-0032 is in the development process; therefore, a copy is not yet available for review. HCA would appreciate any input or concerns regarding this SPA. To request a copy when it becomes available or submit comments, please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).