AN ACT relating to Medicaid coverage for doula services.

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AN ACT relating to Medicaid coverage for doula services. 1
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 2
SECTION 1. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 3
READ AS FOLLOWS: 4
(1) As used in this section, "doula" means a trained professional who provides 5
physical, emotional, and educational support, but not medical care, to women 6
before, during, and after childbirth. 7
(2) The Department for Medicaid Services and any managed care organization with 8
whom the department contracts for the delivery of Medicaid services shall provide 9
coverage for doula services if the doula has: 10
(a) Applied for and recei ved a national Provider Identification Number from 11
the federal Centers for Medicare and Medicaid Services; and 12
(b) Completed enrollment as a Medicaid provider, as may be required by the 13
Department for Medicaid Services. 14
(3) The Department for Medicaid Services shall: 15
(a) Prior to enrolling doulas as Medicaid providers and in collaboration with 16
the Doula Advisory Counci l established in Section 2 of this Act, establish 17
training and credentialing requirements for doulas; and 18
(b) Promulgate administrative regulations in accordance with KRS Chapter 19
13A necessary to carry out this section. 20
SECTION 2. A NEW SECTION OF KRS CHAPTER 194A IS CREATED TO 21
READ AS FOLLOWS: 22
(1) The Doula Advisory Council is hereby established within the Department for 23
Public Health. 24
(2) The council shall consist of the following twenty (20) members: 25
(a) The commission er of the Department for Public Health or his or her 26
designee who shall serve as chair of the council; 27
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(b) The commissioner of the Department for Behavioral Health, Developmental 1
and Intellectual Disabilities or his or her designee; 2
(c) The director of the Division of Maternal and Child Health or his or her 3
designee; 4
(d) The executive director of the Kentucky Association of Health Plans or his 5
or her designee; 6
(e) Eight (8) individuals appointed by the commissioner of the Department for 7
Public Health of which at least one (1) shall be: 8
1. A mother who has used doula services for at least two (2) child births; 9
2. A certified nurse midwife; 10
3. A certified professional midwife; 11
4. A representative of the Kentucky Hospital Association selected from a 12
list of three (3) names provided by the Kentucky Hospital Association; 13
5. An obstetrician with demonstrated work -related experience in 14
community, health equity, and training in equitable healthcare 15
practices; 16
6. A representative of a community -based maternal and chil d health 17
organization; and 18
7. A representative of a local health department working in maternal and 19
child health; and 20
(f) Eight (8) individuals who are actively practicing as doulas in the 21
Commonwealth appointed by the commissioner of the Department for 22
Public Health of which: 23
1. One (1) shall reside in and represent each of the eight (8) federal 24
Centers for Medicare and Medicaid Services regions in Kentucky; and 25
2. At least one (1) shall be a doula with lactation training. 26
(3) Members of the council who ar e not state employees shall be reimbursed for 27
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necessary and actual expenses, including child care. 1
(4) The council shall meet at least quarterly and at other times as it determines may 2
be necessary to perform its duties. A majority of the members shall con stitute a 3
quorum for the transaction of the council's business. 4
(5) The duties of the council shall include: 5
(a) Making recommendations to the Department for Medicaid Services for: 6
1. Training, credentialing, and continuing education standards to be 7
required for a doula to be eligible for Medicaid enrollment; 8
2. Standards for recognizing doula training curricula and practical 9
experience that may be sufficient to satisfy training, credentialing, and 10
continuing education requirements; and 11
3. Establishing scope of practice for doulas, including prenatal and 12
postnatal services and labor and delivery support; 13
(b) Conducting a continuous review of doula training programs; and 14
(c) Advising the Department for Public Health on: 15
1. Increasing access to education and resources for pregnant women and 16
their families; 17
2. Improving access to doula services; and 18
3. Furthering interagency efforts to address maternal health disparities. 19
(6) In making recom mendations to the Department for Medicaid Services for 20
training and credentialing requirements as required under subsection (5)(a) of 21
this section, the council shall consider both formal training programs and 22
previous experience an individual may have as a doula or in providing doula 23
services. 24
Section 3. If the Cabinet for Health and Family Services or the Department for 25
Medicaid Services determines that a state plan amendment, waiver, or any other form of 26
authorization or approval from any federal agency to implement Section 1 or 2 of this Act 27
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is necessary to prevent the loss of federal funds or to comply with federal law, the cabinet 1
or department: 2
(1) Shall, within 90 days after the effective date of this section, reque st the 3
necessary federal authorization or approval to implement Sections 1 and 2 of this Act; 4
and 5
(2) May only delay implementation of the provisions of Sections 1 and 2 of this 6
Act for which federal authorization or approval was deemed necessary until the federal 7
authorization or approval is granted. 8
Section 4. Sections 1, 2, and 3 of this Act shall constitute the specific 9
authorization required under KRS 205.5372(1). 10