Code of the District of Columbia

§ 3–1206.72. Reimbursement for doula services.

(a) By October 1, 2022, health insurance coverage through Medicaid or the DC HealthCare Alliance and the Immigrant Children's Program shall cover and reimburse eligible services provided by doulas; except, that no Medicaid payment shall be made until such time that the Centers for Medicare and Medicaid Services approves the Medicaid state plan amendment described in subsection (b) of this section.

(b)(1) By September 30, 2022, the Department of Health Care Finance ("DHCF") shall submit for approval from the Centers for Medicare and Medicaid Services an amendment to the Medicaid state plan to authorize the Medicaid payments described in this section.

(2) While preparing the Medicaid state plan amendment application, DHCF shall:

(A) In consultation with organizations providing doula services and other relevant entities, establish processes for billing and reimbursement of doula services, including:

(i) Setting competitive reimbursement rates;

(ii) Setting a reasonable number of doula visits to be reimbursed during the course of the pregnancy and postpartum period;

(iii) Developing program support and training for doula service providers to facilitate billing; and

(iv) Assessing the viability of incentive payments to doulas whose clients attend postpartum appointments with a medical provider.

(B) In consultation with the Department of Health and other relevant entities, issue rules to determine eligibility for reimbursement by Medicaid, the DC HealthCare Alliance, and the Immigrant Children's Program.