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A04048
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
1608
Session of
2023
INTRODUCED BY CEPHAS, MADDEN, SANCHEZ, HANBIDGE, KRAJEWSKI,
ISAACSON, HILL-EVANS, SCHLOSSBERG, RABB, MAYES, KHAN, GUENST,
PARKER, FIEDLER, HOHENSTEIN, O'MARA, OTTEN, BULLOCK, KIM,
KINKEAD, CURRY, FLEMING AND GREEN, AUGUST 7, 2023
REFERRED TO COMMITTEE ON HEALTH, AUGUST 7, 2023
AN ACT
Amending the act of June 13, 1967 (P.L.31, No.21), entitled "An
act to consolidate, editorially revise, and codify the public
welfare laws of the Commonwealth," in public assistance,
providing for medical assistance reimbursement coverage for
doula services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of June 13, 1967 (P.L.31, No.21), known
as the Human Services Code, is amended by adding a section to
read:
Section 449.3. Medical Assistance Reimbursement for Doula
Services.--(a) The department shall provide reimbursement to a
certified doula for providing childbirth education and support
services, including physical and emotional support, to an
individual covered under the medical assistance program during
pregnancy, labor and delivery and up to one year postpartum.
(b) The department shall maintain a registry of certified
doulas who have met the requirements provided under subsection
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(d) and are entitled to reimbursement under this section.
(c) Reimbursement under subsection (a) shall include
reimbursement for travel time or mileage expenses in accordance
with the annually scheduled rates determined by the Internal
Revenue Service.
(d) To be listed on the registry of certified doulas and
receive reimbursement under subsection (a), a doula shall:
(1) Receive and maintain certification by an approved
national certification agency identified by the department.
(2) Obtain additional training to be reimbursed by an
employer at a rate determined by the employer, focused on:
(i) Doula care for special populations.
(ii) Becoming a Medicaid participating provider.
(iii) Any additional topics as the department may require.
(3) Submit the following information to the department for
the purpose of performing a background check:
(i) A report of Federal criminal history record information.
(ii) A report of criminal history record information from
the Pennsylvania State Police as provided under 18 Pa.C.S. Ch.
91 (relating to criminal history record information) or a
statement from the Pennsylvania State Police that the
Pennsylvania State Police central repository contains no
information relating to the individual. The criminal history
record information shall be limited to the information which is
disseminated under 18 Pa.C.S. ยง 9121(b)(2) (relating to general
regulations).
(iii) Fingerprints to the Pennsylvania State Police, its
agent or an agent approved for fingerprinting by the Federal
Government. The fingerprints may be used by the Pennsylvania
State Police to conduct a criminal background check and shall be
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forwarded to the Federal Bureau of Investigation for a national
criminal background check.
(4) Maintain personal liability insurance.
(e) The department shall:
(1) Develop a Doula Advisory Board to act as a workgroup to
determine the education requirements and approved accreditation
entities from which a doula may receive certification. The
following shall apply:
(i) The Doula Advisory Board shall include a diverse
membership, including providers, administrators and community
members, including the following:
(A) The secretary.
(B) A representative from the Department of State.
(C) A representative from the Office of Medical Assistance
Programs within the department.
(D) A representative from the Bureau of Family Health within
the Department of Health.
(E) A representative from the Office of Health Equity within
the Department of Health.
(F) A representative from a nationally recognized doula
organization.
(G) Practicing doulas in this Commonwealth.
(H) A member of the Maternal Mortality Review Committee
established under the act of May 9, 2018 (P.L.118, No.24), known
as the Maternal Mortality Review Act.
(ii) The Doula Advisory Board shall be responsible for
developing and updating a list that includes the approved
entities from which individuals seeking doula certification may
gain the necessary education requirements under subsection (d)
and a list of core competencies necessary to be met through the
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training curriculum. The list shall be updated on a quarterly
basis and shall be published on the department's publicly
accessible Internet website.
(iii) All departments, commissions, agencies and public
authorities of the Commonwealth shall provide the Doula Advisory
Board with any reasonably requested assistance or information in
a timely manner in order for the Doula Advisory Board to fulfill
its duties.
(iv) The Doula Advisory Board shall report the information
required under this paragraph to the department on a regular
basis.
(2) Set the rates of reimbursement for doula services
rendered to a medical assistance enrollee.
(f) The department shall seek a State plan amendment or
Federal waiver from the Centers for Medicare and Medicaid
Services, if needed, to allow the medical assistance program to
provide coverage for doula services in accordance with this
section.
(g) As used in this section, the term "doula" shall mean a
professional trained to provide physical, emotional and
informational support to a mother before, during and after
childbirth.
Section 2. If a necessary State plan amendment or Federal
waiver under section 449.3(f) of the act is approved by the
Centers for Medicare and Medicaid Services, the Secretary of
Human Services shall transmit notice of the approval to the
Legislative Reference Bureau for publication in the next
available issue of the Pennsylvania Bulletin.
Section 3. This act shall take effect as follows:
(1) Except as provided under paragraph (2), the addition
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of section 449.3 of the act shall take effect 30 days
following publication of the notice under section 2 of this
act.
(2) The addition of section 449.3(e) and (f) of the act
shall take effect immediately.
(3) The remainder of this act shall take effect
immediately.
Section 443.15. Medical Assistance Coverage for Doula
Services.--(a) Subject to Federal approval, doula services are
compensable under the medical assistance program for eligible
and enrolled medical assistance recipients during pregnancy,
labor and delivery and up to one year postpartum.
(b) The department shall establish a Doula Advisory Board to
advise the secretary regarding the following:
(1) Doula best practices.
(2) Doula participation in the medical assistance program.
(3) Racial and geographic disparities in the provision of
maternal health services.
(4) Equity and inclusion best practices.
(c) The Doula Advisory Board shall include the following:
(1) The secretary.
(2) A representative from the Department of State.
(3) A representative from the Office of Medical Assistance
Programs within the department.
(4) A representative from the Bureau of Family Health within
the Department of Health.
(5) A representative from the Office of Health Equity within
the Department of Health.
(6) A representative from a nationally recognized doula
organization.
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(7) A doula practicing in this Commonwealth.
(8) A member of the Maternal Mortality Review Committee
established under the act of May 9, 2018 (P.L.118, No.24), known
as the Maternal Mortality Review Act.
(9) A member of a commission that supports doula practice in
Pennsylvania.
(10) As deemed appropriate by the department, any other
residents of this Commonwealth who represent the diverse
demographics of Pennsylvania.
(d) The department shall seek a State plan amendment or
Federal waiver from the Centers for Medicare and Medicaid
Services, if needed, for provision of doula services under the
medical assistance program.
(e) As used in this section, the term "doula" shall mean a
professional trained to provide physical, emotional and
informational support to a pregnant individual before, during
and after childbirth.
Section 2. If a necessary State plan amendment or Federal
waiver under section 443.15 of the act is approved by the
Centers for Medicare and Medicaid Services, the Secretary of
Human Services shall transmit notice of the approval to the
Legislative Reference Bureau for publication in the next
available issue of the Pennsylvania Bulletin.
Section 3. This act shall take effect as follows:
(1) Except as provided under paragraph (2), the addition
of section 443.15 of the act shall take effect 30 days
following publication of the notice under section 2 of this
act.
(2) The addition of section 443.15(b) and (c) of the act
shall take effect immediately.
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(3) The remainder of this act shall take effect
immediately.
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