49-20-422. Coverage of pregnancy and childbirth services, including doula, direct- entry midwife, and birthing center services.
(1) As used in this section: "Doula" means an individual who: provides information and physical and emotional support: to a pregnant or postpartum individual; and related to the pregnant or postpartum individual's pregnancy; and is certified by one or more organizations approved by the program. "Pregnancy and childbirth services" means services provided to a pregnant individual before, during, or shortly after childbirth: by a doula for the services described in Subsectionsand; and (1)(a)(i) (ii) at a birthing center that: is licensed under, or accredited by the Commission for the Accreditation of Birth Centers; and Title 26B, Chapter 2, Licensing and Certifications may include services by a direct-entry midwife licensed under, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as defined in Section. Title 58, Chapter 77, Direct-Entry Midwife Act 58-77-102 "Qualified individual" means a covered individual who is: within the state employees' risk pool; and is pregnant; or 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, including limits based on: (2) the type or number of services provided; a qualified individual's physical or emotional condition; and 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, including: (2) covered providers; covered services; provider payment rates; covered-individual cost sharing; total provider payments and covered-individual cost sharing; and any indicators of whether pregnancy and childbirth services covered under Subsectionhave: (2) reduced pregnancy or postpartum coverage costs; or improved pregnancy or postpartum care.