| 12 | 13 | | A BILL TO BE ENTITLED 1 |
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| 13 | 14 | | AN ACT TO REQUIRE NC MEDICAID TO COVER DOULA SERVICES DURING 2 |
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| 14 | 15 | | PREGNANCY AND THE POSTPARTUM PERIOD AND TO PROVIDE FUNDING FOR 3 |
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| 15 | 16 | | SUPPORT SERVICES TO THE DOULA WORKFORCE . 4 |
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| 16 | 17 | | The General Assembly of North Carolina enacts: 5 |
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| 17 | 18 | | SECTION 1.(a) The Department of Health and Human Services, Division of Health 6 |
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| 18 | 19 | | Benefits (DHB), shall seek approval from the Centers for Medicare and Medicaid Services 7 |
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| 19 | 20 | | (CMS) to implement Medicaid coverage of certain healthcare services provided by a doula. DHB 8 |
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| 20 | 21 | | shall develop the parameters of services to be covered, including updating applicable clinical 9 |
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| 21 | 22 | | coverage policies, developing appropriate reimbursement for covered services provided by a 10 |
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| 22 | 23 | | doula, and determining provider credentialing requirements for participation in the NC Medicaid 11 |
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| 23 | 24 | | program. In determining provider credentialing requirements, DHB shall consider education and 12 |
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| 24 | 25 | | experience in the following areas: 13 |
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| 25 | 26 | | (1) Basic newborn care. 14 |
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| 26 | 27 | | (2) Childbirth education. 15 |
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| 27 | 28 | | (3) Client self-advocacy and empowerment techniques. 16 |
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| 28 | 29 | | (4) Common medical interventions, including risks, benefits, and decision 17 |
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| 29 | 30 | | making. 18 |
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| 30 | 31 | | (5) Coping strategies and nonmedical comfort measures during labor and birth. 19 |
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| 31 | 32 | | (6) Lactation support, education, and infant feeding. 20 |
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| 32 | 33 | | (7) Community resource referrals. 21 |
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| 33 | 34 | | (8) Cultural awareness and cross-cultural communication. 22 |
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| 34 | 35 | | SECTION 1.(b) The coverage required by this section shall be implemented as soon 23 |
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| 35 | 36 | | as practicable upon approval by CMS. DHB shall report to the Joint Legislative Oversight 24 |
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| 36 | 37 | | Committee on Medicaid no later than March 1, 2026, regarding the details of the Medicaid 25 |
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| 37 | 38 | | coverage of healthcare services provided by a doula, the specific reimbursement for these 26 |
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| 38 | 39 | | services, and the estimated recurring cost to the State of providing this coverage. 27 |
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| 39 | 40 | | SECTION 2.(a) There is appropriated from the General Fund to the Department of 28 |
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| 40 | 41 | | Health and Human Services, Division of Health Benefits, the sum of one million dollars 29 |
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| 41 | 42 | | ($1,000,000) in recurring funds for each year of the 2025-2027 fiscal biennium to implement the 30 |
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| 42 | 43 | | Medicaid-related changes outlined in this act. These funds shall provide a State match for one 31 |
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| 43 | 44 | | million eight hundred twenty-six thousand dollars ($1,826,000) in recurring federal funds for 32 |
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| 44 | 45 | | each year of the 2025-2027 fiscal biennium, and those federal funds are appropriated to the 33 |
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| 45 | 46 | | Division of Health Benefits to pay for costs associated with the Medicaid-related changes 34 |
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