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Clarifying differences between HERC guidance and Board of Direct Entry Midwifery rules

Wednesday, March 02, 2016

​Per OAR 332-015-0000, Oregon's Board of Direct Entry Midwifery (Board) "determines practice standards, education and training, and provides consultation to the Health Licensing Office on all disciplinary issues in accordance with ORS 687.405 to 687.495." The laws and rules governing the licensees of the Board can be found here.

The mission of the Health Evide​nce Review Commission (HERC) is to "[review] clinical evidence in order to guide the Oregon Health Authority (OHA) in making benefit-related decisions for its health plans. Its main products are the Prioritized List of Health Services, used by the legislature to guide funding decisions for the Oregon Health Plan, and evidence-based reports on specific topics of interest to Oregon health payers and providers as well as members of the public."

HERC recently released coverage guidance regarding planned out-of-hospital birth, which can be found on the HERC site.

Though the Board of Direct Entry Midwifery and HERC are both under the umbrella of the Oregon Health Authority, their statutes and rules are separate.

It should be noted that the Board's practice standards or administrative rules differ from the coverage guidance recommended by the HERC in some areas. If a licensed direct entry midwife bills the Oregon Health Plan for a patient, generally OHA would follow HERC's coverage guidance, not the practice standards adopted by the Board.

Learn more about HERC and see its laws and rules here.


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