(a) “Doula” has the meaning given that term in ORS 414.667.
(b) “Lactation counselor” and “lactation educator” have the meanings given those terms in ORS 676.665.
(2) A health benefit plan, as defined in ORS 743B.005, in this state that reimburses the cost of pregnancy and childbirth expenses shall provide coverage for services provided by doulas, lactation counselors and lactation educators.
(3) Covered services required under subsection (2) of this section shall include a minimum of 24 hours of services, in addition to labor and delivery services, regardless of birth outcome, with an option for the health benefit plan to approve additional hours based on need.
(4) Except for coverage of additional hours based on need as described in subsection (3) of this section, the health benefit plan described in subsection (2) of this section may not require prior authorization, a referral from another health care provider or a signature from or supervision by any other health care provider for coverage of services described in this section.
(5) A health benefit plan that provides the services described in subsection (2) of this section shall provide information on how to access doulas, lactation counselors and lactation educators to all enrollees.
(6) The coverage required by subsection (2) of this section may be made subject to provisions of the policy, certificate or contract that apply to other benefits under the policy, certificate or contract, including, but not limited to, provisions related to deductibles and coinsurance.
(7) The health benefit plan shall reimburse the cost for coverage of services described in this section up to a total amount that is not less than $3,760. On January 1 of each year, the Department of Consumer and Business Services shall adjust the dollar limit provided by this subsection to reflect the percentage changes in the Consumer Price Index for all Urban Consumers, West Region (All Items), as published by the Bureau of Labor Statistics of the United States Department of Labor or a successor agency, and may vary from year to year.
(8) This section is exempt from ORS 743A.001. [2025 c.539 §17]
Note: 743A.081 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.
Note: Sections 21 and 24, chapter 539, Oregon Laws 2025, provide:
Sec. 21. The Department of Consumer and Business Services shall issue guidance on the implementation of section 17 of this 2025 Act [743A.081], including alignment with the rules and requirements for doulas, lactation counselors and lactation educators as described by the Oregon Health Authority. [2025 c.539 §21]
Sec. 24. Section 21 of this 2025 Act is repealed on January 2, 2027. [2025 c.539 §24]