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

353 words·~2 min read·/ut/title-49/chapter-20/49-20-422

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/3/2023

(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

(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.

Enacted by Chapter 292 , 2023 General Session