SENATE BILL REPORT

                   HB 2031

              As Reported By Senate Committee On:

          Health & Long-Term Care, February 23, 2000

Title:  An act relating to adding midwives to the definition of health care practitioners that provide women's health care services.

Brief Description:  Including midwives in women's health care services.

Sponsors:  Representatives Ruderman, Dunn, Dickerson, Fortunato, Conway, Boldt, Kessler, Murray, O'Brien, Romero, Cairnes, Ogden, Rockefeller, Linville, Kenney, Edmonds, Schual‑Berke, Kagi, Tokuda, McIntire, Keiser, Cooper, Lantz, Santos and Miloscia.

Brief History:

Committee Activity:  Health & Long-Term Care:  2/17/2000, 2/23/2000 [DP].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass.

  Signed by Senators Thibaudeau, Chair; Wojahn, Vice Chair; Costa, Deccio, Franklin, Johnson and Winsley.

Staff:  Jinnah Rose-McFadden (786-7444)

Background:  Under current law, health insurance plans must provide women with direct access to certain types of health care providers without requiring a prior referral from another provider.  Licensed midwives are not among the list of providers to whom these direct access provisions apply.

Summary of Bill:  Insurers must provide women with direct access to licensed midwives.

Appropriation:  None.

Fiscal Note:  Requested on March 1, 1999.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  In 1995 the Legislature passed a law requiring health carriers to provide female enrollees with direct access to women's health care service providers, without prior referral from a primary care provider or gatekeeper.  The law includes a nonexclusive list of women's health providers that women may access directly.  Licensed midwives are the only licensed women's health providers excluded from this list.

While carriers have the discretion to allow enrollees to self-refer to midwives, in practice many carriers require a prior referral.  Some women have reported difficulties in obtaining such a referral; in some cases it has taken months to receive an appropriate referral.

In addition, the policies of carriers often change over time.  Some women have reported that despite receiving assurances at an early stage of pregnancy that midwifery services would be covered by the carrier, medical claims have been denied after the birth of a child.

At the time of passage, licensed midwives were excluded from the list of women's health providers because malpractice insurance was not readily available to the profession.  However, since 1995, licensed midwives have obtained access to malpractice insurance.  Therefore, licensed midwives should be added to the list of providers that women may access directly.

Testimony Against:  None.

Testified:  PRO:  Patty Hayes, Department of Health; Nick Federici, Midwives Association; Lee Anne Shelly, midwife.