First Lady Murphy, Human Services Commissioner Adelman announce enhanced NJ FamilyCare maternal health care reimbursement

NEW JERSEY –  First Lady Tammy Murphy and Human Services Commissioner Sarah Adelman Tuesday announced that NJ FamilyCare has increased reimbursement rates for perinatal, midwifery and community doula care as part of ongoing efforts to improve birth outcomes and make New Jersey the safest, most equitable state in the nation to deliver and raise a baby.

The increases are retroactively effective as of July 1, and made possible by $15 million appropriated in the most recent state budget – matched by $15 million in federal funding – and federal approvals secured by Human Services for NJ FamilyCare, which is the state’s Medicaid and CHIP program.

NJ FamilyCare covers approximately 30,000 New Jersey births each year, or about 30 percent of births in the state.

Under the changes:

• Reimbursement rates for physicians and midwives will match 100 percent of current Medicare rates for certain maternity-related services, up from 50 percent.
• All midwives will receive the same reimbursement rate as physicians for all covered services. This includes midwifery care outside of maternity-related care, such as routine gynecological care.
• Community doulas will receive $1,165 for labor support and eight perinatal visits, up from $900.

These changes are part of Human Services’ ongoing efforts to support the First Lady’s NurtureNJ effort, which aims to reduce maternal mortality in the state by 50 percent over five years and eliminate the racial disparities in birth outcomes.

“Raising the reimbursement rates for our maternal care providers is both a groundbreaking and commonsense step toward improving New Jersey’s maternal health outcomes,” Murphy said. “I thank Commissioner Adelman and her team at the Department of Human Services for their essential advocacy that has placed New Jersey’s reimbursement rates among the highest in the nation. Ensuring every New Jersey mother and baby has access to quality maternal health care gets us one important step closer to becoming the gold standard of maternal and infant health.”

Commissioner Adelman noted the changes stem in part from feedback and advocacy from midwives and community doulas.

“Our shared goal is making transformational change in New Jersey to support mothers and babies – especially our mothers and babies of color,” Adelman said. “These improvements further promote access to care associated with improved birth outcomes, and make sure our rates are competitive so we can retain and recruit high quality perinatal providers and community doulas. These enhancements will lead to positive outcomes for mothers and babies – and a healthier New Jersey for everyone.”

Other steps taken by Nurture NJ and the Department of Human Services to promote high-quality maternity-related care within NJ FamilyCare include:

• Promoting high quality care through a statewide perinatal episode of care pilot that tests an alternative payment model for prenatal, labor, and postpartum services;
• Expanding coverage for 365 days postpartum;
• Covering community doula care;
• Allowing all licensed midwives to participate as NJ FamilyCare providers;
• Ending reimbursement for medically-unnecessary early elective deliveries; and
• Requiring perinatal risk assessments during a member’s prenatal care to help identify risk factors and healthcare needs.