Enrolled Copy H.B. 415
1 MATERNAL COVERAGE AMENDMENTS
2 2023 GENERAL SESSION
3 STATE OF UTAH
4 Chief Sponsor: Ashlee Matthews
5 Senate Sponsor: Luz Escamilla
6Cosponsors:
7Gay Lynn Bennion
8Kera Birkeland
9Joel K. Briscoe
10Tyler Clancy
11Jennifer Dailey-Provost
Stephanie Gricius
Sahara Hayes
Sandra Hollins
Marsha Judkins
Rosemary T. Lesser
Carol S. Moss
Karen M. Peterson
Angela Romero
Douglas R. Welton
12
13LONG TITLE
14General Description:
15 This bill requires the Public Employees' Benefit and Insurance Program to cover
16pregnancy and childbirth services.
17Highlighted Provisions:
18 This bill:
19 <defines terms;
20 <requires coverage of pregnancy and childbirth services by the Public Employees'
21Benefit and Insurance Program, including:
22 Cdoula services;
23 Cservices by a licensed direct-entry midwife; and
24 Cservices at a free-standing birthing center;
25 <requires the program to report on its coverage of pregnancy and childbirth services
26to the Health and Human Services Interim Committee; and
27 <provides a repeal date.
28Money Appropriated in this Bill: H.B. 415 Enrolled Copy
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29 None
30Other Special Clauses:
31 None
32Utah Code Sections Affected:
33AMENDS:
34 63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
35ENACTS:
36 49-20-422, Utah Code Annotated 1953
37
38Be it enacted by the Legislature of the state of Utah:
39 Section 1. Section 49-20-422 is enacted to read:
40 49-20-422. Coverage of pregnancy and childbirth services, including doula,
41direct-entry midwife, and birthing center services.
42 (1) As used in this section:
43 (a) "Doula" means an individual who:
44 (i) provides information and physical and emotional support:
45 (A) to a pregnant or postpartum individual; and
46 (B) related to the pregnant or postpartum individual's pregnancy; and
47 (ii) is certified by one or more organizations approved by the program.
48 (b) "Pregnancy and childbirth services" means services provided to a pregnant
49individual before, during, or shortly after childbirth:
50 (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and
51 (ii) at a birthing center that:
52 (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
53Inspection Act, or accredited by the Commission for the Accreditation of Birth Centers; and
54 (B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77,
55Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry
56midwifery, as defined in Section 58-77-102. Enrolled Copy H.B. 415
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57 (c) "Qualified individual" means a covered individual who is:
58 (i) within the state employees' risk pool; and
59 (ii) (A) is pregnant; or
60 (B) was pregnant within the past six months.
61 (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
62program shall cover pregnancy and childbirth services to a qualified individual.
63 (3) The program may establish limits for coverage under Subsection (2), including
64limits based on:
65 (a) the type or number of services provided;
66 (b) a qualified individual's physical or emotional condition; and
67 (c) conditions for provider participation.
68 (4) The program shall report to the Health and Human Services Interim Committee on
69or before October 1 of each year regarding coverage provided under Subsection (2), including:
70 (a) covered providers;
71 (b) covered services;
72 (c) provider payment rates;
73 (d) covered-individual cost sharing;
74 (e) total provider payments and covered-individual cost sharing; and
75 (f) any indicators of whether pregnancy and childbirth services covered under
76Subsection (2) have:
77 (i) reduced pregnancy or postpartum coverage costs; or
78 (ii) improved pregnancy or postpartum care.
79 Section 2. Section 63I-2-249 is amended to read:
80 63I-2-249. Repeal dates: Title 49.
81 (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
82repealed January 1, 2030.
83 (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
84repealed July 1, 2027. H.B. 415 Enrolled Copy
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85