Use of Certified Nurse-Midwives Gao ID: HRD-88-25 November 27, 1987

Pursuant to a congressional request, GAO: (1) assessed states' coverage of certified nurse-midwife services under the Medicaid program; and (2) determined what federal sanctions were available against states that did not comply with federal regulations for such coverage.

GAO found that: (1) all states have laws or regulations allowing nurse-midwives to practice; (2) 44 states cover such services under their Medicaid program and are in compliance with federal regulations; (3) the Health Care Financing Administration (HCFA) is working with six states to bring their plans into compliance with Medicaid requirements; and (4) HCFA has not applied its only available sanction, complete withdrawal of federal Medicaid funds, to the noncompliant states. GAO also found that: (1) Illinois and Kansas plan to amend their Medicaid plans to cover nurse-midwife services; (2) Missouri plans to implement claims processing and payment procedures for such services in December 1987; (3) Nebraska is revising its Medicaid plan to cover nurse-midwife services; and (4) Tennessee and Texas are working with HCFA to eliminate their plans' restrictions on nurse-midwife services.

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