HLS 23RS-649 ORIGINAL
2023 Regular Session
HOUSE BILL NO. 272
BY REPRESENTATIVE WILLARD
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
INSURANCE/HEALTH: Provides relative to maternity support services of doulas
1 AN ACT
2To amend and reenact R.S. 22:1059.2 and to enact R.S. 22:1059.3, relative to maternity
3 support services provided by doulas; to require health insurance coverage for such
4 maternity support services; to provide for legislative findings; to provide for
5 definitions; to provide for the redesignation of certain statutes; to provide for
6 effectiveness; and to provide for related matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1059.2 is hereby amended and reenacted and R.S. 22:1059.3 is
9hereby enacted to read as follows:
10 §1059.2. Required coverage for maternity support services provided by doulas;
11 legislative findings; definitions
12 A. The legislature hereby finds and affirms all of the following:
13 (1) A doula is an individual who has been trained to provide physical,
14 emotional, and educational support, but not medical or midwifery care, to pregnant
15 and birthing women and their families before, during, and after childbirth.
16 (2) Leading professional societies such as the American College of
17 Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, and
18 federal agencies such as the Centers for Disease Control and Prevention, the Health
19 Resources and Services Administration, and the Centers for Medicare and Medicaid
20 Services have recognized the well-established benefits of maternity support services
21 provided by doulas.
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HB NO. 272
1 (3) Research has demonstrated that support from a doula is associated with
2 lower cesarean section rates, fewer obstetric interventions, fewer complications
3 during and after childbirth, decreased use of pain medication, shorter labor hours,
4 and higher scores on the Apgar test, which indicates how well a baby is doing
5 outside the womb.
6 (4) As Louisiana currently ranks as a state with one of the highest maternal
7 and infant mortality rates in the United States, this state has a compelling interest in
8 and obligation to promote practices that improve maternal and infant health
9 outcomes.
10 B.(1) A health coverage plan delivered or issued for delivery in this state that
11 provides benefits for maternity services shall include coverage for maternity support
12 services provided by a doula before, during, and after childbirth.
13 (2) The coverage required pursuant to this Section may be subject to annual
14 deductibles, coinsurance, and copayment provisions as are consistent with those
15 established under the health coverage plan.
16 (3)(a) The requirements established by a health coverage plan to insure the
17 maternity support services provided by a doula before, during, and after childbirth
18 shall not preclude a doula from practice in this state.
19 (b) A doula may opt to practice in this state and forego any eligible
20 reimbursement via a health coverage plan; however, a doula opting for
21 reimbursement via a health coverage plan shall apply to the Louisiana Doula
22 Registry Board for registration and receive an approved registration status.
23 (4) Terminology in any health coverage plan policy or contract deemed
24 discriminatory against doulas or maternity support services provided by doulas is
25 void and unenforceable.
26 C. For purposes of this Section, the following definitions apply:
27 (1) "Doula" means the same as the term is defined in R.S. 22:1059.1.
28 (2) "Health coverage plan" means the same as the term is defined in R.S.
29 22:1059.
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HB NO. 272
1 (3) "Maternity support services" means the physical, emotional, and
2 educational support services provided by a doula to pregnant and birthing women
3 and their families before, during, and after childbirth. "Maternity support services"
4 includes postpartum bereavement support.
5 §1059.3. Required coverage for prescribed donor human milk
6 A health coverage plan issued for delivery, delivered, renewed, or otherwise
7 contracted for in this state shall provide inpatient and outpatient coverage benefits
8 for up to two months for medically necessary pasteurized donor human milk upon
9 prescription of an infant's pediatrician or licensed pediatric provider stating that the
10 infant is medically or physically unable to receive maternal human milk or
11 participate in breastfeeding, or the infant's mother is medically or physically unable
12 to produce maternal human milk in sufficient quantities. A health coverage plan may
13 limit coverage under this Section to inpatient and outpatient donor human milk
14 obtained from a member bank of the Human Milk Banking Association of North
15 America.
16 Section 2. The provisions of this Act apply to any new policy, contract, program, or
17health coverage plan issued on and after January 1, 2024. Any policy, contract, or health
18coverage plan in effect prior to January 1, 2024, shall convert to conform to the provisions
19of this Act on or before the renewal date, but no later than January 1, 2024.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 272 Original 2023 Regular Session Willard
Abstract: Requires health insurance coverage for maternity support services provided by
a doula.
Proposed law affirms a doula as an individual who is trained to provide physical, emotional,
and educational support, but not medical or midwifery care, to pregnant and birthing women
and their families before, during, and after childbirth.
Proposed law outlines legislative findings with respect to doulas. Affirms the state of La.
as a state with one of the highest maternal and infant mortality rates in the U.S. Further
affirms that the state of La. has a compelling interest and obligation to promote practices that
improve maternal and infant health outcomes.
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HB NO. 272
Proposed law requires a health coverage plan delivered or issued for delivery in this state
that provides benefits for maternity services to include coverage for maternity support
services provided by a doula before, during, and after childbirth. Further provides that such
coverage may be subject to annual deductibles, coinsurance, and copayment provisions as
are consistent with those established under the health coverage plan.
Proposed law prohibits a health coverage plan from prescribing coverage requirements for
maternity support services of a doula that preclude a doula from practice in this state.
Authorizes a doula to practice in this state while foregoing eligible reimbursement via a
health coverage plan; however, proposed law requires a doula opting for reimbursement via
a health coverage plan to have approved registration with the La. Doula Registry Board.
Proposed law prohibits terminology in any health coverage plan or contract deemed
discriminatory against doulas and maternity support services provided by doulas. Further
provides that such terminology is void and unenforceable.
Proposed law defines "doula", "health coverage plan", and "maternity support services".
Proposed law applies to a policy, contract, or health coverage plan issued on and after Jan.
1, 2024 and requires a current policy, contract, or plan to convert to the provisions of
proposed law by Jan. 1, 2024.
Present law (R.S. 22:1059.2) requires a health coverage plan to provide inpatient and
outpatient coverage benefits for up to 2 months for medically necessary pasteurized donor
human milk under certain conditions. Proposed law redesignates the citation of present law
from R.S. 22:1059.2 to R.S. 22:1059.3 and otherwise retains present law.
(Amends R.S. 22:1059.2; Adds R.S. 22:1059.3)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.