Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1240 Compare Versions

Only one version of the bill is available at this time.

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2	2	HOUSE DOCKET, NO. 2452 FILED ON: 1/19/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1240
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Lindsay N. Sabadosa and Liz Miranda
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to Medicaid coverage for doula services.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Lindsay N. Sabadosa1st Hampshire1/19/2023Liz MirandaSecond Suffolk1/19/2023Mindy Domb3rd Hampshire1/20/2023Bud L. Williams11th Hampden1/20/2023Jack Patrick Lewis7th Middlesex1/23/2023Patricia A. Haddad5th Bristol1/24/2023Tram T. Nguyen18th Essex1/25/2023Brian W. Murray10th Worcester1/25/2023David Henry Argosky LeBoeuf17th Worcester1/25/2023David Paul Linsky5th Middlesex1/26/2023Christine P. Barber34th Middlesex1/27/2023David M. Rogers24th Middlesex1/27/2023Carmine Lawrence Gentile13th Middlesex1/27/2023Kay Khan11th Middlesex2/1/2023Michael P. Kushmerek3rd Worcester2/2/2023Thomas M. Stanley9th Middlesex2/3/2023Ruth B. Balser12th Middlesex2/3/2023Christopher J. Worrell5th Suffolk2/7/2023 2 of 2
16	16	Sean Garballey23rd Middlesex2/8/2023Jason M. LewisFifth Middlesex2/9/2023William J. Driscoll, Jr.7th Norfolk2/10/2023Michelle L. Ciccolo15th Middlesex2/13/2023James C. Arena-DeRosa8th Middlesex2/14/2023Jacob R. OliveiraHampden, Hampshire and Worcester2/14/2023Kate Donaghue19th Worcester2/14/2023Margaret R. Scarsdale1st Middlesex2/15/2023Adrianne Pusateri Ramos14th Essex2/15/2023Angelo J. Puppolo, Jr.12th Hampden2/17/2023Erika Uyterhoeven27th Middlesex2/22/2023Samantha Montaño15th Suffolk2/24/2023Rebecca L. RauschNorfolk, Worcester and Middlesex3/6/2023Rodney M. Elliott16th Middlesex3/9/2023Lydia EdwardsThird Suffolk3/9/2023 1 of 8
17	17	HOUSE DOCKET, NO. 2452 FILED ON: 1/19/2023
18	18	HOUSE . . . . . . . . . . . . . . . No. 1240
19	19	By Representative Sabadosa of Northampton and Senator Miranda, a joint petition (accompanied
20	20	by bill, House, No. 1240) of Lindsay N. Sabadosa, Liz Miranda and others relative to Medicaid
21	21	coverage for doula services. Health Care Financing.
22	22	The Commonwealth of Massachusetts
23	23	_______________
24	24	In the One Hundred and Ninety-Third General Court
25	25	(2023-2024)
26	26	_______________
27	27	An Act relative to Medicaid coverage for doula services.
28	28	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
29	29	of the same, as follows:
30	30	1 SECTION 1: Chapter 118E of the General Laws is hereby amended by inserting after
31	31	2section 10N the following section:-
32	32	3 Section 10-O: Medicaid Coverage for Doula Services.
33	33	4 (A) For purposes of this section, the term “doula services” shall have the following
34	34	5meaning:
35	35	6 “Doula Services” are physical, emotional, and informational support, but not medical
36	36	7care, provided by trained doulas to individuals and families during and after pregnancy, labor,
37	37	8childbirth, miscarriage, stillbirth or pregnancy loss. Doula services include but are not limited to:
38	38	9 (1) continuous labor support;
39	39	10 (2) prenatal, postpartum, and bereavement home or in-person visits throughout the
40	40	11perinatal period, lasting until 1 year after birth, pregnancy loss, stillbirth, or miscarriage; 2 of 8
41	41	12 (3) accompanying pregnant individuals to health care and social services appointments;
42	42	13 (4) providing support to individuals for loss of pregnancy or infant from conception
43	43	14 through one year postpartum;
44	44	15 (5) connecting individuals to community-based and state- and federally-funded
45	45	16resources, including those which address social determinants of health;
46	46	17 (6) making oneself available (being on-call) around the time of birth or loss as well as
47	47	18providing support for any concerns of pregnant individuals throughout pregnancy and until one
48	48	19year after birth, pregnancy loss, stillbirth, or miscarriage.
49	49	20 (7) providing support for other individuals providing care for a birthing parent,
50	50	21including a birthing parent’s partner and family members.
51	51	22 (B) Coverage of Doula Services:
52	52	23 (1) The Division shall provide coverage of doula services to pregnant individuals and
53	53	24postpartum individuals up to 12 months following the end of the pregnancy who are eligible for
54	54	25medical assistance under this chapter and/or through Title XIX or Title XXI of the Social
55	55	26Security Act. The Division shall provide the same coverage of doula services to pregnant and
56	56	27postpartum individuals who are not otherwise eligible for medical assistance under this chapter
57	57	28or Titles XIX or XXI of the Social Security Act solely because of their immigration status.
58	58	29 (2) The Division must cover continuous support through labor and childbirth, and at least
59	59	30up to six doula visits across the prenatal and one year postpartum period, including at least two
60	60	31postpartum visits, without the need for prior authorization. The Division must also establish a
61	61	32procedure to cover additional doula visits as needed. 3 of 8
62	62	33 (C) Creation of Doula Advisory Committee: There is hereby created a Doula Advisory
63	63	34Committee.
64	64	35 (1) The committee shall consist of 10-12 members to be appointed by the commissioner
65	65	36of public health, or designee.
66	66	37 (a) All but 2 of the members must be practicing doulas from the community; the
67	67	38remaining 2 members must be individuals from the community who have experienced pregnancy
68	68	39as a MassHealth member and are not practicing doulas.
69	69	40 (b) Among the members described in (a) above:
70	70	41 (i) at least 1 member must be a person who identifies as belonging to the LGBTQIA+
71	71	42community;
72	72	43 (iii) at least 1 member must be a person who has experienced a severe maternal
73	73	44morbidity, a perinatal mental health or mood disorder, or a near-death experience while pregnant
74	74	45or in maternity care;
75	75	46 (iv) at least 1 member must be a person who identifies as a person with disabilities or
76	76	47disabled person;
77	77	48 (c) The members of the committee shall represent a diverse range of experience levels-
78	78	49from doulas new to the practice to more experienced doulas.
79	79	50 (d) The members of the committee shall be from areas within the Commonwealth where
80	80	51maternal and infant outcomes are worse than the state average, as evidenced by the MA
81	81	52Department of Public Health’s most current perinatal data available at the time the member is
82	82	53appointed. 4 of 8
83	83	54 (e) The members of the committee shall represent an equitable geographic distribution
84	84	55from across the Commonwealth.
85	85	56 (2) The committee must be convened within six months of passage of this law.
86	86	57 (3) Of the initial appointments to the Doula Advisory Committee, half shall be appointed
87	87	58to a term of 2 years and half shall be appointed to a term of 18 months. Thereafter, all terms shall
88	88	59be 2 years. The commissioner of public health, or designee, shall fill vacancies as soon as
89	89	60practicable.
90	90	61 (4) At least once every 8 weeks, the Division must meet with the Doula Advisory
91	91	62Committee to consult about at least the following:
92	92	63 (a) the scope of doula services covered by MassHealth;
93	93	64 (b) doula competencies required for reimbursement by MassHealth, and standards of
94	94	65proof or demonstration of those competencies;
95	95	66 (c) the recruitment of a diverse workforce of doulas to provide services to MassHealth
96	96	67members;
97	97	68 (d) the development of comprehensive and high quality continuing education and
98	98	69training that is free or low cost to doulas committed to providing services to MassHealth
99	99	70members, as well as the development of mentorship and career growth opportunities for doulas
100	100	71providing services to MassHealth members;
101	101	72 (e) the performance of any third party administrators of MassHealth’s doula coverage
102	102	73program, and standards and processes around billing for and prompt reimbursement of doula
103	103	74services; 5 of 8
104	104	75 (f) establishing grievance procedures for doulas, MassHealth members, and health care
105	105	76providers about MassHealth’s coverage of doula services and/or the provision of doula services
106	106	77to MassHealth members;
107	107	78 (g) outreach to the public and stakeholders about how to access doula care for
108	108	79MassHealth members, and about the availability of and advantages of doula care;
109	109	80 (h) the evaluation and collection of data on the provision of, outcomes of, access to, and
110	110	81satisfaction with doula care services provided to MassHealth members;
111	111	82 (i) maintaining a reimbursement rate for doula services that incentivizes and supports a
112	112	83diverse workforce representative of the communities served, and establishing a recurring
113	113	84timeframe to review that rate in light of inflation and changing costs of living in the
114	114	85commonwealth;
115	115	86 (j) how to ensure that MassHealth’s doula reimbursement program is directed towards
116	116	87the goal of reducing inequities in maternal and birth outcomes among racial, ethnic, and cultural
117	117	88populations who reside in all areas within the commonwealth, as evidenced by the most current
118	118	89perinatal data supplied by the department of public health.
119	119	90 (5) Each year, the Doula Advisory Committee must, by a majority vote of a quorum of its
120	120	91members, select an individual to serve as its chairperson for a one year term. The Doula
121	121	92Advisory Committee may replace the chairperson in the same manner mid-term.
122	122	93 (6) The Doula Advisory Committee may, by a majority vote of a quorum of its members,
123	123	94reduce the frequency of meetings with MassHealth to less than once every 8 weeks. 6 of 8
124	124	95 (7) The division and the Department of Public Health shall seek resources to offer
125	125	96reasonable compensation to members of the Doula Advisory Committee for fulfilling their
126	126	97duties, and must reimburse members for actual and necessary expenses incurred while fulfilling
127	127	98their duties.
128	128	99 (8) The division, in partnership with the Doula Advisory Committee, shall conduct at
129	129	100least 1 public hearing or forum each year until three years after passage of this law. The purposes
130	130	101of these hearings or forums shall be to gather feedback from the public and to inform the public
131	131	102about MassHealth’s coverage of doula care.
132	132	103 SECTION 2. Chapter 29 of the Massachusetts General Laws is hereby amended by
133	133	104inserting after section 2QQQQQ the following section:-
134	134	105 Section 2RRRRR. (a) There shall be established and set up on the books of the
135	135	106commonwealth a separate fund known as the Doula Workforce Development Trust Fund,
136	136	107hereinafter called the fund. The fund shall be administered by the department of career services
137	137	108which shall contract with the Commonwealth Corporation to administer the fund. The fund shall
138	138	109be credited with: (i) revenue from appropriations or other money authorized by the general court
139	139	110and specifically designated to be credited to the fund; (ii) interest earned on such revenues; and
140	140	111(iii) funds from public and private sources; and other gifts, grants and donations for the growth,
141	141	112training and continuous support of the doula workforce. Amounts credited to the fund shall not
142	142	113be subject to further appropriation and any money remaining in the fund at the end of a fiscal
143	143	114year shall not revert to the General Fund.
144	144	115 (b) The Commonwealth Corporation shall make expenditures from the fund for the
145	145	116purposes of: 7 of 8
146	146	117 (i) the development and expansion of comprehensive doula training available across the
147	147	118commonwealth. including the development of doula training focused on meeting the needs of
148	148	119MassHealth members;
149	149	120 (ii) ensuring that doulas committed to serving MassHealth members have access to high
150	150	121quality doula training at no- or low-cost to them;
151	151	122 (iii) the recruitment and retention of doulas from communities with high concentrations
152	152	123of MassHealth members, as well as areas within the commonwealth where maternal and infant
153	153	124outcomes are worse than the state average, as evidenced by the MA Department of Public
154	154	125Health’s perinatal data.
155	155	126 (iv) expanding doula mentoring opportunities across the state, which provide new doulas
156	156	127the opportunity to attend births and incentivize experienced practicing doulas to take on mentees.
157	157	128 (v) leveraging funds to secure future federal funding to support doula workforce
158	158	129development in the commonwealth.
159	159	130 (c) The director of career services shall annually, not later than December 31, report to
160	160	131the secretary of administration and finance, the house and senate committees on ways and means
161	161	132and the joint committee on labor and workforce development on the efforts undertaken in
162	162	133support of section (b) above; the number of doulas recruited and trained as a result of activities
163	163	134taken in support of (b) above, including but not limited to sex, gender identity, race, and ethnicity
164	164	135of such doulas; the amount of grants and identities of grantees awarded in support of section (b)
165	165	136above; and the availability of doula training at no- or low-cost to doulas committed to serving
166	166	137MassHealth members. 8 of 8
167	167	138 SECTION 3: Chapter 111 of the General Laws is hereby amended by inserting in section
168	168	13970E after “Every patient or resident of a facility shall have the right:”:
169	169	140 (p) to have their birth doula’s continuous presence during labor and delivery. Facilities
170	170	141shall not place an undue burden on a patient’s doula’s access to clinical labor and delivery
171	171	142settings, and shall not arbitrarily exclude a patient’s doula from such settings.