The Michigan Department of Health and Human Services (MDHHS) recently released a proposed policy for Medicaid coverage of doula services effective Oct. 1, 2022, contingent upon approval by the Centers for Medicare & Medicaid Services. The MHA supports this proposal and agrees with the MDHHS statement that the policy would improve birth outcomes, address social determinants of health, and decrease health and racial disparities for Medicaid beneficiaries.
A doula is a nonclinical person who typically provides physical, emotional and educational support services to pregnant women during the prenatal, labor and delivery, and postpartum periods. Doulas must have a current certification by a doula training program or organization approved by the MDHHS and provide it upon request. They must complete an online application in the Community Health Automated Processing System and enroll with an Individual National Provider Identifier as either a Rendering/Servicing-Only or Individual/Sole Provider to be a Medicaid-enrolled provider.
Under the proposed policy, Medicaid would cover various types of doula services, including community-based, prenatal, labor and delivery, and postpartum services when recommended by a licensed healthcare provider. Doula services are expected to be in-person, with prenatal and postpartum services available via telehealth when there is a barrier to in-person services. Covered services would include a maximum of six total visits during the prenatal and postpartum periods and one visit for labor and delivery. All prenatal and postpartum visits would need to be at least 20 minutes to be eligible for reimbursement. The proposed payment rate is $75 per visit for prenatal and postnatal visits and $350 for attendance at labor and delivery.
Comments are due to the MDHHS June 4. Members with questions should contact Vickie Kunz at the MHA.
