Utah 2023 Regular Session

Utah House Bill HB0415 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Enrolled Copy H.B. 415
	1	+	1st Sub. H.B. 415
	2	+	LEGISLATIVE GENERAL COUNSEL
	3	+	6 Approved for Filing: D.M. Cheung 6
	4	+	6 02-15-23 1:57 PM 6
	5	+	H.B. 415
	6	+	1st Sub. (Buff)
	7	+	Representative Ashlee Matthews proposes the following substitute bill:
2	8		1 MATERNAL COVERAGE AMENDMENTS
3	9		2 2023 GENERAL SESSION
4	10		3 STATE OF UTAH
5	11		4 Chief Sponsor: Ashlee Matthews
6	12		5 Senate Sponsor: Luz Escamilla
7		-	6Cosponsors:
8		-	7Gay Lynn Bennion
9		-	8Kera Birkeland
10		-	9Joel K. Briscoe
11		-	10Tyler Clancy
12		-	11Jennifer Dailey-Provost
13		-	Stephanie Gricius
14		-	Sahara Hayes
15		-	Sandra Hollins
16		-	Marsha Judkins
17		-	Rosemary T. Lesser
18		-	Carol S. Moss
19		-	Karen M. Peterson
20		-	Angela Romero
21		-	Douglas R. Welton
22		-	12
23		-	13LONG TITLE
24		-	14General Description:
25		-	15 This bill requires the Public Employees' Benefit and Insurance Program to cover
26		-	16pregnancy and childbirth services.
27		-	17Highlighted Provisions:
28		-	18 This bill:
29		-	19 <defines terms;
30		-	20 <requires coverage of pregnancy and childbirth services by the Public Employees'
31		-	21Benefit and Insurance Program, including:
32		-	22 Cdoula services;
33		-	23 Cservices by a licensed direct-entry midwife; and
34		-	24 Cservices at a free-standing birthing center;
35		-	25 <requires the program to report on its coverage of pregnancy and childbirth services
36		-	26to the Health and Human Services Interim Committee; and
37		-	27 <provides a repeal date.
38		-	28Money Appropriated in this Bill: H.B. 415 Enrolled Copy
39		-	- 2 -
40		-	29 None
41		-	30Other Special Clauses:
42		-	31 None
43		-	32Utah Code Sections Affected:
44		-	33AMENDS:
45		-	34 63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
46		-	35ENACTS:
47		-	36 49-20-422, Utah Code Annotated 1953
48		-	37
49		-	38Be it enacted by the Legislature of the state of Utah:
50		-	39 Section 1. Section 49-20-422 is enacted to read:
51		-	40 49-20-422. Coverage of pregnancy and childbirth services, including doula,
52		-	41direct-entry midwife, and birthing center services.
53		-	42 (1) As used in this section:
54		-	43 (a) "Doula" means an individual who:
55		-	44 (i) provides information and physical and emotional support:
56		-	45 (A) to a pregnant or postpartum individual; and
57		-	46 (B) related to the pregnant or postpartum individual's pregnancy; and
58		-	47 (ii) is certified by one or more organizations approved by the program.
59		-	48 (b) "Pregnancy and childbirth services" means services provided to a pregnant
60		-	49individual before, during, or shortly after childbirth:
61		-	50 (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and
62		-	51 (ii) at a birthing center that:
63		-	52 (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
64		-	53Inspection Act, or accredited by the Commission for the Accreditation of Birth Centers; and
65		-	54 (B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77,
66		-	55Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry
67		-	56midwifery, as defined in Section 58-77-102. Enrolled Copy H.B. 415
68		-	- 3 -
69		-	57 (c) "Qualified individual" means a covered individual who is:
70		-	58 (i) within the state employees' risk pool; and
71		-	59 (ii) (A) is pregnant; or
72		-	60 (B) was pregnant within the past six months.
73		-	61 (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
74		-	62program shall cover pregnancy and childbirth services to a qualified individual.
75		-	63 (3) The program may establish limits for coverage under Subsection (2), including
76		-	64limits based on:
77		-	65 (a) the type or number of services provided;
78		-	66 (b) a qualified individual's physical or emotional condition; and
79		-	67 (c) conditions for provider participation.
80		-	68 (4) The program shall report to the Health and Human Services Interim Committee on
81		-	69or before October 1 of each year regarding coverage provided under Subsection (2), including:
82		-	70 (a) covered providers;
83		-	71 (b) covered services;
84		-	72 (c) provider payment rates;
85		-	73 (d) covered-individual cost sharing;
86		-	74 (e) total provider payments and covered-individual cost sharing; and
87		-	75 (f) any indicators of whether pregnancy and childbirth services covered under
88		-	76Subsection (2) have:
89		-	77 (i) reduced pregnancy or postpartum coverage costs; or
90		-	78 (ii) improved pregnancy or postpartum care.
91		-	79 Section 2. Section 63I-2-249 is amended to read:
92		-	80 63I-2-249. Repeal dates: Title 49.
93		-	81 (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
94		-	82repealed January 1, 2030.
95		-	83 (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
96		-	84repealed July 1, 2027. H.B. 415 Enrolled Copy
97		-	- 4 -
98		-	85
	13	+	6
	14	+	7LONG TITLE
	15	+	8General Description:
	16	+	9 This bill requires the Public Employees' Benefit and Insurance Program to cover
	17	+	10pregnancy and childbirth services.
	18	+	11Highlighted Provisions:
	19	+	12 This bill:
	20	+	13 <defines terms;
	21	+	14 <requires coverage of pregnancy and childbirth services by the Public Employees'
	22	+	15Benefit and Insurance Program, including:
	23	+	16 Cdoula services;
	24	+	17 Cservices by a licensed direct-entry midwife; and
	25	+	18 Cservices at a free-standing birthing center;
	26	+	19 <requires the program to report on its coverage of pregnancy and childbirth services
	27	+	20to the Health and Human Services Interim Committee; and
	28	+	21 <provides a repeal date.
	29	+	22Money Appropriated in this Bill:
	30	+	23 None
	31	+	24Other Special Clauses:
	32	+	25 None
	33	+	HB0415S01 1st Sub. (Buff) H.B. 415 02-15-23 1:57 PM
	34	+	- 2 - House Committee Amendments 2-16-2023 pf/dc
	35	+	26Utah Code Sections Affected:
	36	+	27AMENDS:
	37	+	28 63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
	38	+	29ENACTS:
	39	+	30 49-20-422, Utah Code Annotated 1953
	40	+	31
	41	+	32Be it enacted by the Legislature of the state of Utah:
	42	+	33 Section 1. Section 49-20-422 is enacted to read:
	43	+	34 49-20-422. Coverage of pregnancy and childbirth services.
	44	+	35 (1) As used in this section:
	45	+	36 (a) "Doula" means an individual who:
	46	+	37 (i) provides information and physical and emotional support:
	47	+	38 (A) to a pregnant or postpartum individual; and
	48	+	39 (B) related to the pregnant or postpartum individual's pregnancy; and
	49	+	40 (ii) is certified by one or more organizations approved by the program.
	50	+	41 (b) "Pregnancy and childbirth services" means services provided to a pregnant
	51	+	42individual before, during, or shortly after childbirth:
	52	+	43 (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); º and »
	53	+	44 º [(ii) by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry
	54	+	45Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as
	55	+	46defined in Section 58-77-102; or
	56	+	47 (iii)] (ii) » at a birthing center that:
	57	+	48 (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
	58	+	49Inspection Act º [; or] , or accredited by the Commission for the Accreditation of Birth
	59	+	49aCenters; and »
	60	+	50 º [(B) is accredited by the Commission for the Accreditation of Birth Centers.] (B) may
	61	+	50ainclude services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry
	62	+	50bMidwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery,
	63	+	50cas defined in Section 58-77-102. »
	64	+	51 (c) "Qualified individual" means a covered individual who is:
	65	+	52 (i) within the state employees' risk pool; and
	66	+	53 (ii) (A) is pregnant; or
	67	+	54 (B) was pregnant within the past six months.
	68	+	55 (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
	69	+	56program shall cover pregnancy and childbirth services to a qualified individual. 02-15-23 1:57 PM 1st Sub. (Buff) H.B. 415
	70	+	- 3 - House Committee Amendments 2-16-2023 pf/dc
	71	+	57 (3) The program may establish limits for coverage under Subsection (2), including
	72	+	58limits based on:
	73	+	59 (a) the type or number of services provided; º [and] »
	74	+	60 (b) a qualified individual's physical or emotional condition º [.] ; and
	75	+	60a (c) conditions for provider participation. »
	76	+	61 (4) The program shall report to the Health and Human Services Interim Committee on
	77	+	62or before October 1 of each year regarding coverage provided under Subsection (2), including:
	78	+	63 (a) covered providers;
	79	+	64 (b) covered services;
	80	+	65 (c) provider payment rates;
	81	+	66 (d) covered-individual cost sharing;
	82	+	67 (e) total provider payments and covered-individual cost sharing; and
	83	+	68 (f) any indicators of whether pregnancy and childbirth services covered under
	84	+	69Subsection (2) have:
	85	+	70 (i) reduced pregnancy or postpartum coverage costs; or
	86	+	71 (ii) improved pregnancy or postpartum care.
	87	+	72 Section 2. Section 63I-2-249 is amended to read:
	88	+	73 63I-2-249. Repeal dates: Title 49.
	89	+	74 (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
	90	+	75repealed January 1, 2030.
	91	+	76 (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
	92	+	77repealed July 1, 2027.