The Michigan Department of Health and Human Services recently released a second proposed policy to establish coverage for doula services effective Jan. 1, 2023. The MHA supports this proposal and agrees with the MDHHS statement that the policy will improve birth outcomes, address social determinants of health and decrease health and racial disparities for Medicaid beneficiaries. Changes from the previous proposal include:
- Specifying a per visit payment rate of $75 for prenatal and postnatal visits which must be at least 20 minutes in duration.
- Allowing prenatal and postnatal services to be provided via telehealth without documenting barriers to in-person services.
- Covering a maximum of six visits as initially proposed with potential coverage of additional visits through prior authorization.
- Increasing the payment rate for the labor and delivery visit from $350 to $700.
- Clarifying that services will be reimbursed through the MDHHS for Medicaid fee-for-service beneficiaries and the Medicaid Health Plans (MHPs) for beneficiaries enrolled in an MHP.
- Clarifying that Medicaid covers childbirth education and lactation support and counseling separately from doula services.
The initial list of training programs within the proposed policy was compiled during policy development with the assistance of doulas. The MDHHS will continue to review doula training programs, including those created for specific populations such as community-based doula programs, to support cultural and community needs. The MDHHS will also continue to research pathways for legacy certification, or certification of doulas by providing proof of experience in lieu of training, within the confines of state and federal regulations. Opportunities to assist doula providers in navigating the Medicaid program is also being explored.