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TRICARE Policy Manual 6010.60-M, April 1, 2015
Providers
Chapter 11
Section 11.2
Birthing Center Certification Process
Issue Date:  May 23, 1988
Revision:  
1.0  ISSUE
What is the process to certify a birthing center?
2.0  POLICY
2.1  Each contractor is the certifying authority and has participation agreement signatory authority for Defense Health Agency (DHA) for birthing center applicants located within their geographical jurisdiction.
2.2  The contractor is to notify DHA in writing of the appointment and removal of each person designated by the contractor to sign a birthing center participation agreement. The appointment or removal notification must include the individual’s full name as signed, name, title, position, signature sample (for notice of appointment only) and the effective date of the action. No more than two individuals will be so authorized by the contractor concurrently, and the effective date of appointment will be no earlier than the date of the written notice of appointment to DHA.
2.3  DHA is direct recipient of each birthing center report of a beneficiary death or emergency transfer to an acute care facility and is responsible for taking appropriate action to determine whether a reporting birthing center should remain an authorized institutional provider.
2.4  Each contractor will provide timely written notice of the effective date of the revocation of a birthing center’s authorized provider status to DHA, to each beneficiary actually admitted to the birthing center program on the date the revocation notice was issued, and to the Military Treatment Facility (MTF)/Enhanced Multi-Service Market (eMSM) Commanding Officer when the birthing center is within a Prime service area.
3.0  POLICY CONSIDERATIONS
3.1  Application. A complete application for certification as an authorized birthing center consists of an application signed and dated by the Chief Executive Officer (CEO) of the center which provides:
3.1.1  The complete name and street address of the center;
3.1.2  The mailing address for correspondence;
3.1.3  The name and title of the Chief Operating Officer (COO);
3.1.4  A routine and emergency phone number for the COO;
3.1.5  The type of legal organization of the center;
3.1.6  The name and business address of each member of the center’s governing body; and
3.1.7  Legible photocopies of:
•  All current operating licenses;
•  The most recent notice of accreditation;
•  The most recent of each required memorandum of understanding; and
•  Such supplementary information as may be required on a case-by-case basis to determine the safety and appropriateness of the center’s operation.
3.2  Development. The certifying authority shall make at least one request for information missing from an application.
3.3  Decision notice. The certification decision shall be rendered within 60 days of the receipt by the certifying authority of a complete application.
3.4  Rejected application. A center shall be notified in writing that it is no longer considered an applicant for certification when a pending incomplete application is not made complete within 60 days of the date of a written notice to the center of the deficiencies of the center’s application unless the certifying authority has extended the response time for good reason.
3.5  Denied application. A center shall be notified in writing of the specific reason(s) that certification is not granted.
3.6  Certification. Authorization of a center as an institutional provider shall be made only after the certifying authority is:
3.6.1  Satisfied that the information provided in the complete application is true and current, and is
3.6.2  Satisfied that the applicant complies in all respects with the requirements of the 32 CFR 199, and is
3.6.3  Satisfied that the applicant is not otherwise barred from provider status, and
3.6.4  The applicant has returned a signed participation agreement.
3.7  Provider identification. Each authorized birthing center will be assigned a unique identification number regardless of its affiliation with another authorized provider or group of authorized providers.
3.8  Amended application. An applicant or authorized center is required to amend a pending or approved application within 30 days of a change in any of the information required for application.
3.9  Compliance verification. The certifying authority shall maintain contemporary documentation that the currency of each approved birthing center’s application materials has been verified at least at 24-month intervals following initial approval as an institutional provider.
3.10  Birthing Center participation agreement. The text of the participation agreement for freestanding or institution-affiliated birthing center maternity care services for beneficiaries is at Addendum C. The contractor is not authorized to make any change in the language of this agreement. Applicant specific changes to this agreement will not be considered by DHA.
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