88R10192 SCP-D
 
  By: Walle H.B. No. 3394
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to Medicaid coverage and reimbursement for doula services
  and reports on the provision of those services.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 32, Human Resources Code,
  is amended by adding Section 32.02481 to read as follows:
         Sec. 32.02481.  MEDICAL ASSISTANCE FOR DOULA SERVICES. (a)
  In this section:
               (1)  "Doula" means a nonmedical birthing coach who
  provides doula services.
               (2)  "Doula services" means nonmedical childbirth
  education, coaching, and support services, including emotional and
  physical support provided during pregnancy, labor, delivery, and
  for up to twelve months after birth during the postpartum period, or
  provided intermittently during pregnancy and the postpartum
  period. The term includes the referral of pregnant and postpartum
  individuals to community-based organizations, social service
  organizations, and licensed perinatal professionals.
               (3)  "Recipient" means a medical assistance program
  recipient.
         (b)  The commission shall ensure that medical assistance
  reimbursement is provided to a doula in accordance with this
  section for the provision of doula services to a pregnant or
  postpartum recipient.
         (c)  To be eligible for reimbursement under the medical
  assistance program, a doula must:
               (1)  be at least 18 years of age;
               (2)  have an assigned national provider identifier
  number, as defined by Section 531.021182, Government Code;
               (3)  be accredited by a doula training organization
  recognized by a regional or statewide doula association, including
  the Texas Doula Association, and provide to the commission a
  certified copy of the accreditation;
               (4)  provide to the commission documentation
  evidencing:
                     (A)  completion of not less than 24 in-person or
  virtual classroom hours that include any combination of doula
  training, childbirth education and training, or postpartum
  training;
                     (B)  attendance at a breastfeeding peer support
  training or other certified lactation counselor training;
                     (C)  attendance at one or more childbirth
  education trainings;
                     (D)  attendance at two or more child births;
                     (E)  completion of a cultural competency
  training;
                     (F)  completion of a training on the Health
  Insurance Portability and Accountability Act of 1996 (42 U.S.C.
  Section 1320d et seq.) and other patient confidentiality laws; and
                     (G)  completion of a cardiopulmonary
  resuscitation training;
               (5)  complete applicable medical assistance program
  application and enrollment processes; and
               (6)  satisfy any other requirements the commission
  determines appropriate.
         (d)  A doula who is included on an exclusion list published
  by a statewide or regional doula association, including the Texas
  Doula Association, or who engages in the practice of medicine may
  not:
               (1)  enroll as a provider under the medical assistance
  program; or 
               (2)  otherwise receive reimbursement under the
  program.
         (e)  Notwithstanding Subsection (c), a doula who does not
  meet the qualifications described by that subsection may receive
  medical assistance reimbursement if the doula provides to the
  commission documentation the commission determines sufficient
  evidencing that the doula has provided doula services for not less
  than 12 consecutive months before reimbursement is provided. A
  doula who is eligible to receive reimbursement under this
  subsection must:
               (1)  complete any applicable medical assistance
  program application and enrollment processes; and
               (2)  complete any courses or training necessary to meet
  the qualifications described by Subsection (c) not later than 12
  months after the doula's enrollment in the medical assistance
  program under this subsection.
         (f)  The executive commissioner by rule shall prescribe the
  services for which a doula may receive medical assistance
  reimbursement, which may include:
               (1)  providing culturally informed services to support
  a recipient during pregnancy and the postpartum period;
               (2)  advocating for and supporting a recipient's
  perinatal choices, including choices related to childbirth,
  breastfeeding, and parenting;
               (3)  providing support through the use of traditional
  comfort measures or the provision of educational materials during
  pregnancy, labor, and childbirth and assisting a recipient in the
  transition to parenthood, including through home visits;
               (4)  offering evidence-based counseling and education
  on infant care, family dynamics, feeding, emotional and physical
  recovery from birth, and other issues related to pregnancy or the
  postpartum period;
               (5)  providing physical and emotional support during
  and after labor;
               (6)  facilitating access to community-based support
  services to improve birth outcomes, including transportation,
  housing, substance use cessation, family violence resources, and
  other state or federal assistance programs;
               (7)  referring recipients to health care providers to
  receive medical care or counseling as necessary;
               (8)  working as part of a recipient's multidisciplinary
  team; and
               (9)  providing counseling or bereavement support on
  pregnancy or infant loss.
         (g)  The commission may authorize a doula to provide any of
  the services described by Subsection (f) using telecommunications
  or information technology.
         (h)  The commission shall establish:
               (1)  a separate provider type for doulas for purposes
  of enrollment as a provider; and 
               (2)  a medical assistance reimbursement rate for the
  provision of doula services to a recipient.
         (i)  The commission shall establish a statewide registry
  accessible to the public on the commission's Internet website that
  contains a list of doulas enrolled as a provider under the medical
  assistance program.
         (j)  Not later than September 1 of each year, the commission,
  in collaboration with each managed care organization that has a
  doula in the organization's provider network, shall prepare and
  submit to the legislature a written report on cost and utilization
  information related to the reimbursement and provision of doula
  services under this section.
         SECTION 2.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 3.  This Act takes effect September 1, 2023.