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 DSHS 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.
During the 2019 legislative session, THA worked closely with state lawmakers to 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. DSHS will be required to conduct a strategic revenue of the practice implementation of the neonatal and maternal designation process.
- HB 1164 (87th Texas Legislature) – Relating to patient safety practices regarding placenta accreta spectrum disorder.
- 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.
THA Comments on Hospital Level of Care Designation for Neonatal Care (Feb. 28, 2022)
Public Comment Form – Designation Requirements for Placenta Accreta Spectrum Disorder (Aug. 20, 2021) | DSHS
Placenta Accreta Spectrum Disorder Subcommittee Charter (Aug. 18, 2021) | DSHS
FAQs on NICU Designation Process (Oct. 24, 2018) | DSHS
TMHP Update on Neonatal Level of Care Designations (Aug. 31, 2018) | DSHS
Neonatal System Development Web page (August 2018) | DSHS
Neonatal Facility Designation Applications for Levels 1-IV
- LEVEL I FORMS
- LEVEL II-IV FORMS
- Neonatal designation rule, effective June 9, 2016. Read more
- Overview of Hospital Level of Care Designations for Neonatal Care (June 9, 2016) | DSHS
- Presentation on Level I Neonatal Care Designation (June 13, 2016) | DSHS
- Presentation on Level II Neonatal Care Designation (June 27, 2016) | (DSHS)
- Presentation on Level III Neonatal Care Designation (June 27, 2016) | DSHS