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SECOND REGULAR SESSION
SENATE BILL NO. 1229
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR WASHINGTON.
4463S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto two new sections relating to health insurance
coverage of maternity services.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto 1
two new sections, to be known as sections 376.1755 and 376.1758, 2
to read as follows:3
376.1755. 1. For purposes of this section, the 1
following terms mean: 2
(1) "Certified nurse midwife", the same meaning given 3
to the term in section 335.016; 4
(2) "Health benefit plan", the same meaning given to 5
the term in section 376.1350; 6
(3) "Health carrier", the same meaning given to the 7
term in section 376.1350; 8
(4) "Midwife", a certified nurse midwife or 9
professional midwife; 10
(5) "Professional midwife", any midwife allowed to 11
practice in this state in accordance with the provisions of 12
section 376.1753. 13
2. Each health carrier or health benefit plan that 14
offers or issues health benefit plans that are delivered, 15
issued for delivery, continued, or renewed in this state on 16
or after January 1, 2027, and that provide coverage for 17
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maternity services shall provide coverage for health care 18
services provided by a midwife. 19
3. The coverage provided for in this section may be 20
subject to annual deductibles, coinsurance, and copayments. 21
A health benefit plan subject to the provisions of 22
subsection 2 of this section shall not differentiate between 23
services performed by a midwife within the midwife's lawful 24
scope of practice and services performed by a physician with 25
respect to copayments, annual deductible amounts, or 26
coinsurance percentages. 27
4. Whenever any health benefit plan subject to the 28
provisions of subsection 2 of this section provides for 29
reimbursement of any services that are within the lawful 30
scope of practice of certified nurse midwives and 31
professional midwives, the insured or other person entitled 32
to benefits under the health benefit plan shall be entitled 33
to reimbursement for the services, whether the services are 34
performed by a physician or a midwife. 35
5. Terminology in any health benefit plan subject to 36
the provisions of subsection 2 of this section that is 37
deemed discriminatory against certified nurse midwives, 38
professional midwives, or midwifery or that inhibits 39
reimbursement for midwifery services at the in-network rate 40
is void and unenforceable. 41
6. The provisions of this section shall not apply to a 42
supplemental insurance policy, including a life care 43
contract, accident-only policy, specified disease policy, 44
hospital policy providing a fixed daily benefit only, 45
Medicare supplement policy, long-term care policy, short- 46
term major medical policy of six months or less duration, or 47
any other supplemental policy as determined by the director 48
of the department of commerce and insurance. 49
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376.1758. 1. For purposes of this section, the term 1
"doula" means an individual who has been trained to provide 2
physical, emotional, and educational support, but not 3
medical or midwifery care, to pregnant and birthing women 4
and their families before, during, and after childbirth. 5
2. The department of health and senior services shall 6
review and approve doula registration to allow for health 7
insurance reimbursement of doula services. 8
3. The department of health and senior services shall: 9
(1) Create the criteria for the doula registration 10
application; 11
(2) Review applications for doulas to register to 12
receive health insurance reimbursement in this state; 13
(3) Approve applications to designate registered doula 14
status; 15
(4) Notify applicants of approval or denial of doula 16
registration status; and 17
(5) Maintain a statewide registry of doulas approved 18
for health insurance reimbursement in this state. 19
4. Nothing in this section prohibits any person from 20
practicing as a doula in this state regardless of whether 21
the person is registered in accordance with the provisions 22
of this section. 23
5. The department of health and senior services shall 24
promulgate all necessary rules and regulations for the 25
administration of this section. Any rule or portion of a 26
rule, as that term is defined in section 536.010, that is 27
created under the authority delegated in this section shall 28
become effective only if it complies with and is subject to 29
all of the provisions of chapter 536 and, if applicable, 30
section 536.028. This section and chapter 536 are 31
nonseverable and if any of the powers vested with the 32
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general assembly pursuant to chapter 536 to review, to delay 33
the effective date, or to disapprove and annul a rule are 34
subsequently held unconstitutional, then the grant of 35
rulemaking authority and any rule proposed or adopted after 36
August 28, 2026, shall be invalid and void. 37
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