Senate advances bill to require Medicaid reimbursement for doulas, orders third reading

Senator from Chittenden Central presented S 109 on the Senate floor as a bill that would require Vermont Medicaid to reimburse qualified doulas for doula services, citing research the sponsor said shows doulas reduce cesarean rates and postpartum depression.

The sponsor told colleagues there are "about 70 to a 100 doulas statewide" and described a draft statutory change in which Section 1 would amend "33 BSA 19 1" to require Medicaid coverage for doula services and Section 2 would define a "qualified doula" as someone registered, certified or licensed with the Office of Professional Regulation (OPR). The bill also includes a Sunrise review to determine the most appropriate regulatory model and a requirement that reimbursement rates be reasonable and consistent with other states' Medicaid programs.

During debate the Appropriations Committee presented and the Senate adopted an amendment that removed a near-term appropriation and made the OPR Sunrise review the first step. Under the amendment, OPR will consult stakeholders and consider whether certification, registration, licensure, mentorship or apprenticeship is the right approach; the committee also asked the Department of Vermont Health Access (DVHA) to return with a methodology for estimating costs and to consider whether a waiver or state plan amendment with the Centers for Medicare & Medicaid Services would be required.

The sponsor listed stakeholders who testified to the committee, naming Ashley Berliner (director of Medicaid policy, Department of Vermont Health Access), Rebecca Copens (government and media affairs, Blue Cross Blue Shield of Vermont), Amy Johnson (Vermont Care Partners), Laura Layman (general counsel, Office of Professional Regulation), Matt Levin (Executive Director, Early Childhood Advocacy Alliance), Alex McCracken (communications and legislative affairs), and Sam Paich (health policy analyst, Vermont Legal Aid).

The chamber voted to amend the health and welfare report as offered by Appropriations and ordered S 109 to be read a third time.

Next steps: S 109 was amended as described and the Senate ordered a third reading; the bill will return to the floor for a third reading where final passage and any additional amendments will be decided.