SLS 24RS-533 REENGROSSED 2024 Regular Session SENATE BILL NO. 142 BY SENATOR BARROW MEDICAID. Requires doula services to be covered by Medicaid. (8/1/24) 1 AN ACT 2 To enact R.S. 46:972.1, relative to doula services covered by Medicaid; to provide for 3 legislative findings; to provide for mandatory coverage of doula services by the 4 Medicaid managed care organizations; to provide for coverage periods and service 5 minimums; to provide for a doula to forego reimbursement; to prohibit 6 discriminatory terminology; to provide for contract applicability; and to provide for 7 related matters. 8 Be it enacted by the Legislature of Louisiana: 9 Section 1. R.S. 46:972.1 is hereby enacted to read as follows: 10 ยง972.1. Medicaid covered doula services 11 A. The legislature hereby finds and declares: 12 (1) A doula is an individual who has been trained to provide physical, 13 emotional, and educational support, but not medical or midwifery care, to 14 pregnant and birthing women and their families before, during, and after 15 childbirth. 16 (2) Leading professional societies, such as the American College of 17 Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, Page 1 of 4 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 142 SLS 24RS-533 REENGROSSED 1 and federal agencies, such as the Centers for Disease Control and Prevention, 2 the Health Resources and Services Administration, and the Centers for 3 Medicare and Medicaid Services, have recognized the well-established benefits 4 of doula services. 5 (3) Research has demonstrated that support from a doula is associated 6 with lower cesarean section rates, fewer obstetric interventions, fewer 7 complications during and after childbirth, decreased use of pain medication, 8 shorter labor hours, and higher scores on the APGAR test, which indicates how 9 well the baby is doing outside the womb. 10 (4) As Louisiana currently ranks as a state with one of the highest 11 maternal mortality rates in the United States, this state has an obligation to 12 promote practices that improve maternal health outcomes. 13 B.(1) The Louisiana Department of Health shall require each Medicaid 14 managed care organization that provides health plan benefits for maternity 15 services to include coverage for services provided by a doula before, during, and 16 after childbirth. The coverage may also be subject to a minimum service rate 17 per pregnancy of one thousand two hundred fifty dollars. 18 (2) Each Medicaid managed care organization shall provide coverage for 19 the following service minimums: 20 (a) Three prenatal visits, of up to ninety minutes. 21 (b) Three postpartum visits, of up to ninety minutes. 22 (c) Attendance through labor and birth. 23 C. "Doula services" include the following: 24 (1) Support and assistance during labor and childbirth. 25 (2) Prenatal and postpartum support and education. 26 (3) Breastfeeding assistance and lactation support. 27 (4) Parenting education. 28 (5) Support for a birthing person following loss of pregnancy. 29 D.(1) The requirements established by Medicaid managed care Page 2 of 4 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 142 SLS 24RS-533 REENGROSSED 1 organizations to insure the services provided by a doula before, during, and 2 after childbirth shall not be construed to preclude a doula from practice in this 3 state. A doula may opt to practice in this state and forego any eligible 4 reimbursement from a Medicaid managed care organization. Doulas opting in 5 for reimbursement from a Medicaid managed care organization shall have 6 approved registration with the Louisiana Doula Registry Board. All doulas with 7 approved registration with the Louisiana Doula Registry Board are required to 8 have acceptance as a provider of doula services with all Louisiana Medicaid 9 managed care organizations. 10 (2) Terminology in any Medicaid managed care organization's plan, 11 policy, or contract considered discriminatory against doulas and doula services 12 shall be void and unenforceable. 13 (3) The provisions of this Section shall apply to any new policy, contract, 14 program, or Medicaid health coverage plan issued on and after August 1, 2024. 15 Any policy, contract, or Medicaid health coverage plan in effect prior to August 16 1, 2024, shall convert to conform to the provisions of this Act on or before the 17 renewal date, but no later than January 1, 2025. The original instrument was prepared by Amanda Trapp. The following digest, which does not constitute a part of the legislative instrument, was prepared by Dawn Romero Watson. DIGEST SB 142 Reengrossed 2024 Regular Session Barrow Proposed law provides for legislative intent regarding doulas and doula services. Proposed law requires the La. Department of Hospitals to mandate doula coverage by the Medicaid managed care organizations. Proposed law establishes mandated doula covered services when a managed care organization's health plan provides maternity services. Proposed law provides that proposed law should not be construed to preclude a doula from practicing in Louisiana if they want to forego reimbursement from the Medicaid managed care organization. Proposed law further provides that the doula must have certain approved registration to opt into the Medicaid managed care organization's plan. Proposed law prohibits discriminatory terminology. Page 3 of 4 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions. SB NO. 142 SLS 24RS-533 REENGROSSED Proposed law provides for contract applicability. Effective August 1, 2024. (Adds R.S. 46:972.1) Summary of Amendments Adopted by Senate Senate Floor Amendments to engrossed bill 1. Make technical change. Page 4 of 4 Coding: Words which are struck through are deletions from existing law; words in boldface type and underscored are additions.