LEGISLATIVE FISCAL OFFICE
Fiscal Note
Fiscal Note On: SB 142 SLS 24RS 533
Bill Text Version: REENGROSSED
Opp. Chamb. Action:
Proposed Amd.:
Sub. Bill For.:
Date: May 29, 2024 12:59 PM Author: BARROW
Dept./Agy.: LDH/Medicaid
Subject: Doula Services Analyst: Shawn Hotstream
MEDICAID RE INCREASE GF EX See Note Page 1 of 1
Requires doula services to be covered by Medicaid. (8/1/24)
Proposed law provides Medicaid coverage (through the Managed Care Organizations, MCOs) for doula services before,
during, and after childbirth. Proposed law specifies the specific doula services that are covered by Medicaid.
Proposed law provides that doulas opting in for reimbursement from Medicaid shall have approved registration with the
Louisiana Doula Registry Board, and have acceptance as a provider from all MCOs.
EXPENDITURES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. INCREASE INCREASE INCREASE INCREASE INCREASE
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other INCREASE INCREASE INCREASE INCREASE INCREASE
Federal Funds INCREASE INCREASE INCREASE INCREASE INCREASE
Local Funds $0 $0 $0 $0 $0 $0
Annual Total
REVENUES 2024-25 2025-26 2026-27 2027-28 2028-29 5 -YEAR TOTAL
State Gen. Fd. $0 $0 $0 $0 $0 $0
Agy. Self-Gen. $0 $0 $0 $0 $0 $0
Ded./Other INCREASE INCREASE INCREASE INCREASE INCREASE
Federal Funds $0 $0 $0 $0 $0 $0
Local Funds $0 $0 $0 $0 $0 $0
Annual Total
EXPENDITURE EXPLANATION
Providing Medicaid coverage for inpatient and outpatient doula treatment services is anticipated to result in a significant
increase in Medicaid expenditures annually.
As an illustrative example, if 5% of the approximately 35,196 eligible deliveries utilized doula services with a minimum
service rate of $1,250 per pregnancy, covering doula services could result in a minimum cost of $2.2 M ($385,965 SGF,
$121,584 Stat. Ded., and $1,713,701 Federal) in FY 25, with projected increases in future fiscal years. The estimate is
based on the following assumptions and calculations reflected below.
1) Approximately 35,196 Medicaid eligible deliveries from calendar year 2023
2) Minimum service rate of doula service per delivery = $1,250 (the minimum rate is referenced in the proposed bill)
3) Assume MCOs will not reimburse at a higher level, otherwise cost estimates understated
4) 5% uptake in utilization of service with a 1% increase each year
REVENUE EXPLANATION
Increased premium payments to MCOs will result in additional taxes collected by LDH. Tax revenues are 5.5% of premiums
paid to the MCOs. In the illustrative example in the Expenditure Explanation above, $2.2 M in additional payments for doula
covered services will generate approximately $121,000 in statutory dedication premium tax revenues in FY 25.
Senate Dual Referral Rules House
x 13.5.1 >= $100,000 Annual Fiscal Cost {S & H} x 6.8(F)(1) >= $100,000 SGF Fiscal Cost {H & S}
Patrice Thomas
13.5.2 >= $500,000 Annual Tax or Fee 6.8(G) >= $500,000 Tax or Fee Increase
Change {S & H} or a Net Fee Decrease {S} Deputy Fiscal Officer