Texas 2023 - 88th Regular

Texas House Bill HB3394 Compare Versions

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1	1	88R10192 SCP-D
2	2	By: Walle H.B. No. 3394
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to Medicaid coverage and reimbursement for doula services
8	8	and reports on the provision of those services.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subchapter B, Chapter 32, Human Resources Code,
11	11	is amended by adding Section 32.02481 to read as follows:
12	12	Sec. 32.02481. MEDICAL ASSISTANCE FOR DOULA SERVICES. (a)
13	13	In this section:
14	14	(1) "Doula" means a nonmedical birthing coach who
15	15	provides doula services.
16	16	(2) "Doula services" means nonmedical childbirth
17	17	education, coaching, and support services, including emotional and
18	18	physical support provided during pregnancy, labor, delivery, and
19	19	for up to twelve months after birth during the postpartum period, or
20	20	provided intermittently during pregnancy and the postpartum
21	21	period. The term includes the referral of pregnant and postpartum
22	22	individuals to community-based organizations, social service
23	23	organizations, and licensed perinatal professionals.
24	24	(3) "Recipient" means a medical assistance program
25	25	recipient.
26	26	(b) The commission shall ensure that medical assistance
27	27	reimbursement is provided to a doula in accordance with this
28	28	section for the provision of doula services to a pregnant or
29	29	postpartum recipient.
30	30	(c) To be eligible for reimbursement under the medical
31	31	assistance program, a doula must:
32	32	(1) be at least 18 years of age;
33	33	(2) have an assigned national provider identifier
34	34	number, as defined by Section 531.021182, Government Code;
35	35	(3) be accredited by a doula training organization
36	36	recognized by a regional or statewide doula association, including
37	37	the Texas Doula Association, and provide to the commission a
38	38	certified copy of the accreditation;
39	39	(4) provide to the commission documentation
40	40	evidencing:
41	41	(A) completion of not less than 24 in-person or
42	42	virtual classroom hours that include any combination of doula
43	43	training, childbirth education and training, or postpartum
44	44	training;
45	45	(B) attendance at a breastfeeding peer support
46	46	training or other certified lactation counselor training;
47	47	(C) attendance at one or more childbirth
48	48	education trainings;
49	49	(D) attendance at two or more child births;
50	50	(E) completion of a cultural competency
51	51	training;
52	52	(F) completion of a training on the Health
53	53	Insurance Portability and Accountability Act of 1996 (42 U.S.C.
54	54	Section 1320d et seq.) and other patient confidentiality laws; and
55	55	(G) completion of a cardiopulmonary
56	56	resuscitation training;
57	57	(5) complete applicable medical assistance program
58	58	application and enrollment processes; and
59	59	(6) satisfy any other requirements the commission
60	60	determines appropriate.
61	61	(d) A doula who is included on an exclusion list published
62	62	by a statewide or regional doula association, including the Texas
63	63	Doula Association, or who engages in the practice of medicine may
64	64	not:
65	65	(1) enroll as a provider under the medical assistance
66	66	program; or
67	67	(2) otherwise receive reimbursement under the
68	68	program.
69	69	(e) Notwithstanding Subsection (c), a doula who does not
70	70	meet the qualifications described by that subsection may receive
71	71	medical assistance reimbursement if the doula provides to the
72	72	commission documentation the commission determines sufficient
73	73	evidencing that the doula has provided doula services for not less
74	74	than 12 consecutive months before reimbursement is provided. A
75	75	doula who is eligible to receive reimbursement under this
76	76	subsection must:
77	77	(1) complete any applicable medical assistance
78	78	program application and enrollment processes; and
79	79	(2) complete any courses or training necessary to meet
80	80	the qualifications described by Subsection (c) not later than 12
81	81	months after the doula's enrollment in the medical assistance
82	82	program under this subsection.
83	83	(f) The executive commissioner by rule shall prescribe the
84	84	services for which a doula may receive medical assistance
85	85	reimbursement, which may include:
86	86	(1) providing culturally informed services to support
87	87	a recipient during pregnancy and the postpartum period;
88	88	(2) advocating for and supporting a recipient's
89	89	perinatal choices, including choices related to childbirth,
90	90	breastfeeding, and parenting;
91	91	(3) providing support through the use of traditional
92	92	comfort measures or the provision of educational materials during
93	93	pregnancy, labor, and childbirth and assisting a recipient in the
94	94	transition to parenthood, including through home visits;
95	95	(4) offering evidence-based counseling and education
96	96	on infant care, family dynamics, feeding, emotional and physical
97	97	recovery from birth, and other issues related to pregnancy or the
98	98	postpartum period;
99	99	(5) providing physical and emotional support during
100	100	and after labor;
101	101	(6) facilitating access to community-based support
102	102	services to improve birth outcomes, including transportation,
103	103	housing, substance use cessation, family violence resources, and
104	104	other state or federal assistance programs;
105	105	(7) referring recipients to health care providers to
106	106	receive medical care or counseling as necessary;
107	107	(8) working as part of a recipient's multidisciplinary
108	108	team; and
109	109	(9) providing counseling or bereavement support on
110	110	pregnancy or infant loss.
111	111	(g) The commission may authorize a doula to provide any of
112	112	the services described by Subsection (f) using telecommunications
113	113	or information technology.
114	114	(h) The commission shall establish:
115	115	(1) a separate provider type for doulas for purposes
116	116	of enrollment as a provider; and
117	117	(2) a medical assistance reimbursement rate for the
118	118	provision of doula services to a recipient.
119	119	(i) The commission shall establish a statewide registry
120	120	accessible to the public on the commission's Internet website that
121	121	contains a list of doulas enrolled as a provider under the medical
122	122	assistance program.
123	123	(j) Not later than September 1 of each year, the commission,
124	124	in collaboration with each managed care organization that has a
125	125	doula in the organization's provider network, shall prepare and
126	126	submit to the legislature a written report on cost and utilization
127	127	information related to the reimbursement and provision of doula
128	128	services under this section.
129	129	SECTION 2. If before implementing any provision of this Act
130	130	a state agency determines that a waiver or authorization from a
131	131	federal agency is necessary for implementation of that provision,
132	132	the agency affected by the provision shall request the waiver or
133	133	authorization and may delay implementing that provision until the
134	134	waiver or authorization is granted.
135	135	SECTION 3. This Act takes effect September 1, 2023.