MACPAC study on doulas and community health workers; guidance on increasing access to doula services under Medicaid

(a) MACPAC study on doulas and community health workers (1) In general As part of the first report required under section 1900(b)(1) of the Social Security Act (42 U.S.C. 1396(b)(1)) after the date that is 1 year after the date of enactment of this Act, the Medicaid and CHIP Payment and Access Commission (referred to in this section as MACPAC) shall include with such report a report on the coverage of doula services and the role of community health workers under State Medicaid programs, which shall include the following: (A) Information about coverage for doula services and community health worker services under State Medicaid programs that currently provide coverage for such services, including the type of doula services offered (such as prenatal, labor and delivery, postpartum support, and traditional doula services) and information on the prevalence of doulas that care for individuals in their own communities. (B) An analysis of strategies to facilitate the appropriate use of doula services in order to provide better care and achieve better maternal and infant health outcomes, including strategies that States may use to assist with services for which Federal financial participation is eligible under a State Medicaid plan or a waiver of such a plan by recruiting, training, and certifying a diverse doula workforce, particularly from underserved communities, communities of color, and communities facing linguistic or cultural barriers. (C) Provide examples of community health worker access in State Medicaid programs and strategies employed by States to encourage a broad care team to manage Medicaid patients. (D) An assessment of the impact of the involvement of doulas and community health workers on maternal health outcomes. (E) Recommendations, as MACPAC deems appropriate, for legislative and administrative actions to increase access to services that improve maternal health. (2) Stakeholder consultation In developing the report required under paragraph (1), MACPAC shall consult with relevant stakeholders. (b) Guidance on increasing access to doula services under Medicaid (1) In general Not later than 1 year after the date that MACPAC publishes the report required under subsection (a), the Secretary shall issue guidance to States on increasing access to doula services under Medicaid. Such guidance shall at a minimum include— (A) options for States to provide medical assistance for doula services under State Medicaid programs; (B) best practices for ensuring that doulas, including community-based doulas, receive reimbursement for doula services provided under a State Medicaid program, at a level that allows doulas to earn a living wage that accounts for their time and costs associated with providing care and community-based doula program administration; and (C) best practices for increasing access to doula services, including services provided by community-based doulas, under State Medicaid programs. (2) Stakeholder consultation In developing the report required under paragraph (1), the Secretary shall consult with relevant stakeholders. (c) Relevant stakeholders For purposes of subsections (a)(2) and (b)(2), relevant stakeholders shall include— (1) States; (2) organizations representing consumers, including those that are disproportionately impacted by poor maternal health outcomes; (3) organizations and individuals representing doula services providers and community health workers, including community-based doula programs and those who serve underserved communities, communities of color and communities facing linguistic or cultural barriers; and (4) organizations representing health care providers.