A BILL TO BE ENTITLED
AN ACT to provide coverage for doula services under the north carolina medicaid program state plan.
The General Assembly of North Carolina enacts:
SECTION 1.  The Department of Health and Human Services, Division of Health Benefits, shall submit a State Plan amendment to the Centers for Medicare and Medicaid Services adding coverage under the North Carolina Medicaid State Plan for antepartum, intrapartum, and postpartum services provided to a pregnant recipient by a doula. These services shall include services for labor and delivery support and at least four visits during the antenatal period and seven visits during the postpartum period. This coverage shall begin August 1, 2021.
SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Benefits, the sum of five hundred thousand dollars ($500,000) in nonrecurring funds for the 2020‑2021 fiscal year to be used to make necessary changes to the NCTracks Medicaid Management Information System to add the new coverage required under Section 1 of this act and to enroll new providers of that coverage.
SECTION 3.  In preparation for the addition of the new coverage required under Section 1 of this act, the Department of Health and Human Services, Division of Health Benefits (DHB), shall study the following:
(1)	The necessary qualifications possessed by a doula in order to be enrolled as a North Carolina Medicaid provider, including educational requirements and the possession of any professional certification.
(2)	The scope, definitions, and clinical coverage policy to be used for the provision of these new services.
(3)	The billing codes and procedure codes to be utilized by the doula providers when submitting claims for services.
(4)	The way other states have implemented similar coverage, or plan to implement similar coverage, including any costs associated with that implementation and any costs or costs savings associated with the coverage of services provided by a doula.
(5)	The appropriate rate schedule for the new coverage.
(6)	Any anticipated costs and costs savings to the North Carolina Medicaid Program that may be incurred or achieved by providing coverage for services provided by a doula.
(7)	The potential impact that Medicaid coverage of services provided by a doula may have on infant mortality and maternal health in the State.
No later than April 1, 2021, DHB shall submit to the chairs of the Senate Appropriations Committee on Health and Human Services, the chairs of the House of Representatives Appropriations Committee on Health and Human Services, and the Fiscal Research Division a report on the study conducted in accordance with this section and shall include in that report a copy of the State Plan amendment to establish coverage under the North Carolina Medicaid State Plan for antepartum, intrapartum, and postpartum services provided to a pregnant recipient by a doula, including the proposed reimbursement methodology to be utilized.
SECTION 4.  This act is effective when it becomes law.