Evidence-based Childbirth Program


December 20, 2011 – MHCP Provider Update MHP-11-12

Effective January 1, 2012, Minnesota law:

  • • Asks hospitals to implement policies and processes designed to minimize non-medically necessary inductions before 39 weeks gestation
  • • Requires hospitals to report induction of labor data for all births covered by MHCP
  • • Requires delivering providers to include a form with each delivery claim when the delivery is in a hospital that does not have policies and processes in place for non-medically necessary inductions before 39 weeks gestation

  • Hospital Policy

    MHCP encourages hospitals to have facility and quality improvement (QI) criteria in place and to submit them to MHCP for approval. The facility policy and QI criteria must include the following:

  • • A hard stop policy restricting elective* inductions before 39 weeks gestation. A hard stop policy includes the following elements:
  • • Defined medical indications for induction in policy with any deviation from this policy reviewed by the QI process
  • • Authorization for hospital staff to not schedule an elective induction before 39 weeks gestation
  • • Requirements for providers to get permission from physician leadership (e.g., the head of the OB department) before performing an elective induction before 39 weeks gestation
  • • Provider documentation of final estimated date of delivery (EDD) by 20 weeks gestation (including data from any ultrasound measurement) and share the information with the recipient
  • • Guidelines for recipient education about elective inductions, and documentation of the education recipients receive
  • • Ongoing QI review and facility-level reporting of the number of elective, singleton births (including induction and Cesarean) at 37 to less than 39 weeks gestation divided by total number of singleton deliveries at 37 to less than 39 weeks of gestation
  • • Ongoing audits if the proportion of births using induction at gestations less than 39 weeks is above 25% 
  • • Analysis of provider variation regarding use of elective inductions
  • • Peer review of all inductions less than 39 weeks for appropriateness of indication

  • *Elective is defined as not having a medical/obstetric indication, as defined in the hospital’s QI criteria list.

    MHCP Approval Process

    MHCP will verify facility policies and QI efforts meet hospital policy criteria through a review process. Use the Facility Policy Cover Sheet Evidence-based Childbirth Program (DHS-6470) with appropriate documentation to submit hospital/facility policies for the evidence-based childbirth program.

    If approved, MHCP will:

  • • Notify the facility within five weeks of receipt
  • • Add the hospital name and NPI to a provider list available in MN–ITS for delivering provider reference

  • If denied by the initial review process, MHCP will forward all documents to the Medicaid Medical Director. Facilities may resubmit a request after outstanding items are addressed.

    Facilities will be required to re-attest to their policies and QI processes every 5 years.

    Annual Reporting Requirements

    All hospitals that provide OB delivery care services to MHCP enrollees are required to annually report the following data to MHCP:

  • • Rate of overall early and pre-term induction for all births covered by MHCP (the number of singleton inductions less than 39 weeks gestation divided by the total number of singleton deliveries)
  • • Rate of elective induction at 37 to less than 39 weeks gestation for all births covered by MHCP (the number of elective, singleton births (induction and/or Cesarean) at 37 to less than 39 weeks gestation divided by the total number of singleton deliveries at 37 to less than 39 weeks gestation)
  • MHCP will announce the process for annual reporting (under development) in Provider News.

    Delivering Provider Services

    MHCP encourages delivering providers to review the MN–ITS Evidence-based Hospitals list.

  • • Providers delivering at hospitals included on the list are not required to submit an attachment with their delivery claims
  • • Providers delivering at hospitals not on the list must complete the Non-participating Facility Births Evidence-based Childbirth Program (DHS-6469) form and include the form as a claim attachment with each delivery claim
  • Additional Resources

    MS 256B.0625, subd. 3g Evidence-based childbirth program

    If you have questions about this information, call the MHCP Provider Call Center at (651) 431-2700 or 1-800-366-5411.

    Sign up to receive Provider Updates and other MHCP notices in your e-mail account.


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