Over the past several years, state lawmakers have passed laws changing the way Texas hospitals are reimbursed for neonatal and maternal care provided. The Texas Hospital Association continues to advocate for policies and funding that positions Texas hospitals to provide the highest quality care to all mothers and babies.
The following is a brief history of the neonatal and maternal policy requirements for Texas hospitals.
In 2011, the 83rd Texas Legislature passed House Bill 15, which requires the development of initial rules to create neonatal and maternal level of care designation. The Texas Department of State Health Services' neonatal level of care designation rules took effect June 9, 2016.
In 2013, the 84th Texas Legislature passed House Bill 3433, which requires hospitals that provide neonatal care to have a Level, I, II, III or IV designation from TDSHS by Sept. 1, 2018 to receive Medicaid reimbursements for neonatal services provided. It also requires Texas hospitals to have a maternal Level I, II, III or IV designation by Sept. 1, 2020 to receive Medicaid reimbursements for maternal services provided.
As of Nov. 1, 2018:
20 Texas hospitals received Level IV designations.
55 Texas hospitals received Level III designations. Five facilities requested Level IV designations but received Level III.
76 Texas hospitals received Level II designations. 36 facilities requested Level III designations but received Level II.
82 Texas hospitals received Level I designations.
During the 2019 legislative session, THA worked closely with state lawmakers pass Senate Bill 749, by Sen. Lois Kolkhorst (R-Brenham), which seeks to improve and add flexibility the process by which Texas hospitals receive level of care designations. The legislation adds additional appeal avenues, a waiver process and allow for increased use of telemedicine to meet the standards. TDSHS will be required to conduct a strategic revenue of the practice implementation of the neonatal and maternal designation process.
Resources for Neonatal Designation:
Additional information is available from TDSHS’
Neonatal System Development Web page.
Please contact TDSHS’ Neonatal Designation Coordinators with questions or for further assistance.
Debbie Lightfoot, RN
512-834-6700 ext. 2032
Alisha Wilkin, RN
SB 749 (86th Legislature) - Relating to level of care designations for hospitals that provide neonatal and maternal care.
HB 3433 (84th Legislature) - Relating to level of care designations for hospitals that provide neonatal and maternal care.
HB 15 (83rd Legislature) – Relating to level of care designations for hospitals that provide neonatal and maternal services.