This document includes House Committee Amendments incorporated into the bill on Thu, Feb 16, 2023 at 12:11 PM by pflowers.
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7 LONG TITLE
8 General Description:
9 This bill requires the Public Employees' Benefit and Insurance Program to cover
10 pregnancy and childbirth services.
11 Highlighted Provisions:
12 This bill:
13 ▸ defines terms;
14 ▸ requires coverage of pregnancy and childbirth services by the Public Employees'
15 Benefit and Insurance Program, including:
16 • doula services;
17 • services by a licensed direct-entry midwife; and
18 • services at a free-standing birthing center;
19 ▸ requires the program to report on its coverage of pregnancy and childbirth services
20 to the Health and Human Services Interim Committee; and
21 ▸ provides a repeal date.
22 Money Appropriated in this Bill:
23 None
24 Other Special Clauses:
25 None
26 Utah Code Sections Affected:
27 AMENDS:
28 63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
29 ENACTS:
30 49-20-422, Utah Code Annotated 1953
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32 Be it enacted by the Legislature of the state of Utah:
33 Section 1. Section 49-20-422 is enacted to read:
34 49-20-422. Coverage of pregnancy and childbirth services.
35 (1) As used in this section:
36 (a) "Doula" means an individual who:
37 (i) provides information and physical and emotional support:
38 (A) to a pregnant or postpartum individual; and
39 (B) related to the pregnant or postpartum individual's pregnancy; and
40 (ii) is certified by one or more organizations approved by the program.
41 (b) "Pregnancy and childbirth services" means services provided to a pregnant
42 individual before, during, or shortly after childbirth:
43 (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); Ĥ→ and ←Ĥ
44 Ĥ→ [
45 Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as
46 defined in Section 58-77-102; or
47 (iii)
48 (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
49 Inspection Act Ĥ→ [
49a Centers; and ←Ĥ
50 Ĥ→ [
50a include services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry
50b Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery,
50c as defined in Section 58-77-102. ←Ĥ
51 (c) "Qualified individual" means a covered individual who is:
52 (i) within the state employees' risk pool; and
53 (ii) (A) is pregnant; or
54 (B) was pregnant within the past six months.
55 (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
56 program shall cover pregnancy and childbirth services to a qualified individual.
57 (3) The program may establish limits for coverage under Subsection (2), including
58 limits based on:
59 (a) the type or number of services provided; Ĥ→ [
60 (b) a qualified individual's physical or emotional condition Ĥ→ [
60a (c) conditions for provider participation. ←Ĥ
61 (4) The program shall report to the Health and Human Services Interim Committee on
62 or before October 1 of each year regarding coverage provided under Subsection (2), including:
63 (a) covered providers;
64 (b) covered services;
65 (c) provider payment rates;
66 (d) covered-individual cost sharing;
67 (e) total provider payments and covered-individual cost sharing; and
68 (f) any indicators of whether pregnancy and childbirth services covered under
69 Subsection (2) have:
70 (i) reduced pregnancy or postpartum coverage costs; or
71 (ii) improved pregnancy or postpartum care.
72 Section 2. Section 63I-2-249 is amended to read:
73 63I-2-249. Repeal dates: Title 49.
74 (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
75 repealed January 1, 2030.
76 (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
77 repealed July 1, 2027.