Medicaid Coverage for Doula Services.

GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2025
S 1
SENATE BILL 463

Short Title: Medicaid Coverage for Doula Services. (Public)
Sponsors: Senator Burgin (Primary Sponsor).
Referred to: Rules and Operations of the Senate
March 25, 2025
*S463-v-1*
A BILL TO BE ENTITLED 1
AN ACT TO REQUIRE NC MEDICAID TO COVER D OULA SERVICES DURING 2
PREGNANCY AND THE POSTPARTUM PERIOD AND TO PROVIDE FUNDING FOR 3
SUPPORT SERVICES TO THE DOULA WORKFORCE. 4
The General Assembly of North Carolina enacts: 5
SECTION 1.(a) The Department of Health and Human Services, Division of Health 6
Benefits (DHB), shall seek approval from the Centers for Medicare and Medicaid Services 7
(CMS) to implement Medicaid coverage of certain healthcare services provided by a doula. DHB 8
shall develop the parameters of services to be covered, including updating applicable clinical 9
coverage policies, developing appropriate reimbursement for covered services provided by a 10
doula, and determining provider credentialing requirements for participation in the NC Medicaid 11
program. In determining provider credentialing requirements, DHB shall consider education and 12
experience in the following areas: 13
(1) Basic newborn care. 14
(2) Childbirth education. 15
(3) Client self-advocacy and empowerment techniques. 16
(4) Common medical interventions, including risks, benefits, and decision 17
making. 18
(5) Coping strategies and nonmedical comfort measures during labor and birth. 19
(6) Lactation support, education, and infant feeding. 20
(7) Community resource referrals. 21
(8) Cultural awareness and cross-cultural communication. 22
SECTION 1.(b) The coverage required by this section shall be implemented as soon 23
as practicable upon approval by CMS. DHB shall report to the Joint Legislative Oversight 24
Committee on Medicaid no later than March 1 , 2026, regarding the details of the Medicaid 25
coverage of healthcare services provided by a doula, the specific reimbursement for these 26
services, and the estimated recurring cost to the State of providing this coverage. 27
SECTION 2.(a) There is appropriated from the General Fund to the Department of 28
Health and Human Services, Division of Health Benefits, the sum of one million dollars 29
($1,000,000) in recurring funds for each year of the 2025-2027 fiscal biennium to implement the 30
Medicaid-related changes outl ined in this act. These funds shall provide a State match for one 31
million eight hundred twenty -six thousand dollars ($1,826,000) in recurring federal funds for 32
each year of the 2025 -2027 fiscal biennium, and those federal funds are appropriated to the 33
Division of Health Benefits to pay for costs associated with the Medicaid -related changes 34
outlined in this act. 35
General Assembly Of North Carolina Session 2025
Page 2 Senate Bill 463-First Edition
SECTION 2.(b) There is appropriated from the General Fund to the Department of 1
Health and Human Services, Division of Public Health, the sum of fiv e hundred fifty thousand 2
dollars ($550,000) in recurring funds for each year of the 2025 -2027 fiscal biennium to provide 3
support services and technical assistance to the doula workforce. 4
SECTION 3. Section 2 of this act is effective July 1, 2025. The remainder of this act 5
is effective when it becomes law. 6