SPONSOR: Bosley
This bill requires insurance coverage for childbirth education classes. This requirement is for all individual and group health insurance policies including government plans that are delivered, issued for delivery, continued, or renewed on or after January 1, 2025.
The Department of Social Services shall study the impact that the childbirth education classes have on the infant and maternal mortality of certain pregnant women. The study shall be reported to the General Assembly by January 1, 2027.
This bill also creates the "Missouri Doula Reimbursement Act".
Under the Act, doula services are eligible for coverage throughout the state through MO HealthNet and health benefit plans as specified in the bill. The bill lists conditions that must be met in order for a doula to receive reimbursement including a national provider identification number, approval for all required MO HealthNet program provider enrollment forms, verification of doula training; and providing a signed and dated attestation of being trained and meeting all doula core competency requirements, as specified in the bill. Once enrolled as a program provider for MO HealthNet, doulas shall be eligible to enroll as a provider with certain care services and arrangements affiliated with the MO HealthNet program.
In order to comply with federal Medicaid and private insurance requirements applicable to covered services, doula services will be reimbursed on a fee-for-service schedule. The MO HealthNet coverage available for doula services will be available through one year postpartum, cannot be less than $1500, and will be eligible toward the activities specified within the bill.
The bill specifies which services a doula can provide to pregnant individuals, and stipulates that a doula cannot engage in the practice of medicine as described in Chapter 334, RSMo.
The State Board of Registration for the Healing Arts, within the Department of Commerce and Insurance, will promulgate rules and regulations that establish a doula's area of professional competence and services for the purpose of implementation of this bill as well as establishing a statewide certification for perinatal doulas, solely for the purpose of establishing necessary qualifiers for reimbursement. The MO HealthNet program, managed care organizations, and accountable care payers are required to report utilization and cost information related to perinatal doula services before July 1, 2026, and every July 1 thereafter.
Health carriers and health benefit plans offering or issuing plans must provide coverage for perinatal doula services if said services are within the area of professional competence for perinatal doulas. Supervision, signature, or referral by any other health care provider is not required as a condition of reimbursement, except when those requirements are also applicable to other categories of health care providers. Additionally, health carriers or benefit plans are not required to pay for duplicate services actually rendered by both a perinatal doula and any other health care provider.
Direct payment to perinatal doulas will be contingent upon services rendered in accordance with the rules and regulations promulgated by the State Board of Registration for the Healing Arts. Every health carrier and benefit plan required to cover perinatal services must report utilization and cost information related to these services to the Department of Commerce and Insurance before July 1, 2026, and every July 1 thereafter. Certain provisions of this bill will not apply to certain supplemental insurance policies, as determined by the Director of the Department of Commerce and Insurance.
This bill is similar to HB 1190 (2023).
Statutes affected: