Are Health Maintenance Organizations (HMOs) required to contract with licensed midwives?
Yes. §4303(c) of the NYS Insurance Law mandates coverage of midwifery services. §98.13c of the HMO Regulations is interpreted to require HMO’s and/or Managed Care Organizations (MCO’s) to contract with licensed midwives. Insurance Law §4303(c) can be found at http://assembly.state.ny.us/leg/ – select New York State Laws, then ISC Insurance, and Article 43 to Section 4303. In addition, HMO’s and MCO’s providing services to Medicare and Medicaid beneficiaries must cover services that a midwife is legally authorized to perform under state law or regulations. Information on this requirement may be found at http://assembly.state.ny.us/leg/ – select New York State Laws, then PBH, and Article 44. Chapter 645 of the Laws of 1994: Direct Access for Ob/Gyn Services by HMO Enrollees amended the Public Health Law (4406-b) to provide females with greater flexibility in obtaining primary and preventive Obstetric and Gynecologic services from qualified providers, including licensed midwives, in healt
