§ 49-20-422. Coverage of pregnancy and childbirth services, including doula, direct- entry midwife, and birthing center services.

(1) As used in this section: (a) "Doula" means an individual who: (i) provides information and physical and emotional support: (A) to a pregnant or postpartum individual; and (B) related to the pregnant or postpartum individual's pregnancy; and (ii) is certified by one or more organizations approved by the program. (b) "Pregnancy and childbirth services" means services provided to a pregnant individual before, during, or shortly after childbirth: (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and (ii) at a birthing center that: (A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or accredited by the Commission for the Accreditation of Birth Centers; and (B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as defined in Section 58-77-102. (c) "Qualified individual" means a covered individual who is: (i) within the state employees' risk pool; and (ii) (A) is pregnant; or (B) was pregnant within the past six months. (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the program shall cover pregnancy and childbirth services to a qualified individual. (3) The program may establish limits for coverage under Subsection (2), including limits based on: (a) the type or number of services provided; (b) a qualified individual's physical or emotional condition; and (c) conditions for provider participation. (4) The program shall report to the Health and Human Services Interim Committee on or before October 1 of each year regarding coverage provided under Subsection (2), including: (a) covered providers; (b) covered services; (c) provider payment rates; (d) covered-individual cost sharing; (e) total provider payments and covered-individual cost sharing; and (f) any indicators of whether pregnancy and childbirth services covered under Subsection (2) have: (i) reduced pregnancy or postpartum coverage costs; or (ii) improved pregnancy or postpartum care.