1st Sub. H.B. 415
LEGISLATIVE GENERAL COUNSEL
6 Approved for Filing: D.M. Cheung 6
6 02-15-23 1:57 PM 6
H.B. 415
1st Sub. (Buff)
Representative Ashlee Matthews proposes the following substitute bill:
1 MATERNAL COVERAGE AMENDMENTS
2 2023 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Ashlee Matthews
5 Senate Sponsor: Luz Escamilla
6
7LONG TITLE
8General Description:
9 This bill requires the Public Employees' Benefit and Insurance Program to cover
10pregnancy and childbirth services.
11Highlighted Provisions:
12 This bill:
13 <defines terms;
14 <requires coverage of pregnancy and childbirth services by the Public Employees'
15Benefit and Insurance Program, including:
16 Cdoula services;
17 Cservices by a licensed direct-entry midwife; and
18 Cservices at a free-standing birthing center;
19 <requires the program to report on its coverage of pregnancy and childbirth services
20to the Health and Human Services Interim Committee; and
21 <provides a repeal date.
22Money Appropriated in this Bill:
23 None
24Other Special Clauses:
25 None
*HB0415S01* 1st Sub. (Buff) H.B. 415 02-15-23 1:57 PM
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26Utah Code Sections Affected:
27AMENDS:
28 63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
29ENACTS:
30 49-20-422, Utah Code Annotated 1953
31
32Be it enacted by the Legislature of the state of Utah:
33 Section 1. Section 49-20-422 is enacted to read:
34 49-20-422. Coverage of pregnancy and childbirth services.
35 (1) As used in this section:
36 (a) "Doula" means an individual who:
37 (i) provides information and physical and emotional support:
38 (A) to a pregnant or postpartum individual; and
39 (B) related to the pregnant or postpartum individual's pregnancy; and
40 (ii) is certified by one or more organizations approved by the program.
41 (b) "Pregnancy and childbirth services" means services provided to a pregnant
42individual before, during, or shortly after childbirth:
43 (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); º and »
44 º [(ii) by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry
45Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as
46defined in Section 58-77-102; or
47 (iii)] (ii) » at a birthing center that:
48 (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
49Inspection Act º [; or] , or accredited by the Commission for the Accreditation of Birth
49aCenters; and »
50 º [(B) is accredited by the Commission for the Accreditation of Birth Centers.] (B) may
50ainclude services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry
50bMidwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery,
50cas defined in Section 58-77-102. »
51 (c) "Qualified individual" means a covered individual who is:
52 (i) within the state employees' risk pool; and
53 (ii) (A) is pregnant; or
54 (B) was pregnant within the past six months.
55 (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
56program shall cover pregnancy and childbirth services to a qualified individual. 02-15-23 1:57 PM 1st Sub. (Buff) H.B. 415
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57 (3) The program may establish limits for coverage under Subsection (2), including
58limits based on:
59 (a) the type or number of services provided; º [and] »
60 (b) a qualified individual's physical or emotional condition º [.] ; and
60a (c) conditions for provider participation. »
61 (4) The program shall report to the Health and Human Services Interim Committee on
62or before October 1 of each year regarding coverage provided under Subsection (2), including:
63 (a) covered providers;
64 (b) covered services;
65 (c) provider payment rates;
66 (d) covered-individual cost sharing;
67 (e) total provider payments and covered-individual cost sharing; and
68 (f) any indicators of whether pregnancy and childbirth services covered under
69Subsection (2) have:
70 (i) reduced pregnancy or postpartum coverage costs; or
71 (ii) improved pregnancy or postpartum care.
72 Section 2. Section 63I-2-249 is amended to read:
73 63I-2-249. Repeal dates: Title 49.
74 (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
75repealed January 1, 2030.
76 (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
77repealed July 1, 2027.