Chief Sponsor: Ashlee Matthews

Senate Sponsor: Luz Escamilla

6     Cosponsors:
7     Gay Lynn Bennion
8     Kera Birkeland
9     Joel K. Briscoe
10     Tyler Clancy
11     Jennifer Dailey-Provost
Stephanie Gricius
Sahara Hayes
Sandra Hollins
Marsha Judkins
Rosemary T. Lesser
Carol S. Moss
Karen M. Peterson
Angela Romero
Douglas R. Welton


14     General Description:
15          This bill requires the Public Employees' Benefit and Insurance Program to cover
16     pregnancy and childbirth services.
17     Highlighted Provisions:
18          This bill:
19          ▸     defines terms;
20          ▸     requires coverage of pregnancy and childbirth services by the Public Employees'
21     Benefit and Insurance Program, including:
22               •     doula services;
23               •     services by a licensed direct-entry midwife; and
24               •     services at a free-standing birthing center;
25          ▸     requires the program to report on its coverage of pregnancy and childbirth services
26     to the Health and Human Services Interim Committee; and
27          ▸     provides a repeal date.
28     Money Appropriated in this Bill:

29          None
30     Other Special Clauses:
31          None
32     Utah Code Sections Affected:
33     AMENDS:
34          63I-2-249, as last amended by Laws of Utah 2021, Chapter 64
35     ENACTS:
36          49-20-422, Utah Code Annotated 1953

38     Be it enacted by the Legislature of the state of Utah:
39          Section 1. Section 49-20-422 is enacted to read:
40          49-20-422. Coverage of pregnancy and childbirth services, including doula,
41     direct-entry midwife, and birthing center services.
42          (1) As used in this section:
43          (a) "Doula" means an individual who:
44          (i) provides information and physical and emotional support:
45          (A) to a pregnant or postpartum individual; and
46          (B) related to the pregnant or postpartum individual's pregnancy; and
47          (ii) is certified by one or more organizations approved by the program.
48          (b) "Pregnancy and childbirth services" means services provided to a pregnant
49     individual before, during, or shortly after childbirth:
50          (i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and
51          (ii) at a birthing center that:
52          (A) is licensed under Title 26, Chapter 21, Health Care Facility Licensing and
53     Inspection Act, or accredited by the Commission for the Accreditation of Birth Centers; and
54          (B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77,
55     Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry
56     midwifery, as defined in Section 58-77-102.

57          (c) "Qualified individual" means a covered individual who is:
58          (i) within the state employees' risk pool; and
59          (ii) (A) is pregnant; or
60          (B) was pregnant within the past six months.
61          (2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the
62     program shall cover pregnancy and childbirth services to a qualified individual.
63          (3) The program may establish limits for coverage under Subsection (2), including
64     limits based on:
65          (a) the type or number of services provided;
66          (b) a qualified individual's physical or emotional condition; and
67          (c) conditions for provider participation.
68          (4) The program shall report to the Health and Human Services Interim Committee on
69     or before October 1 of each year regarding coverage provided under Subsection (2), including:
70          (a) covered providers;
71          (b) covered services;
72          (c) provider payment rates;
73          (d) covered-individual cost sharing;
74          (e) total provider payments and covered-individual cost sharing; and
75          (f) any indicators of whether pregnancy and childbirth services covered under
76     Subsection (2) have:
77          (i) reduced pregnancy or postpartum coverage costs; or
78          (ii) improved pregnancy or postpartum care.
79          Section 2. Section 63I-2-249 is amended to read:
80          63I-2-249. Repeal dates: Title 49.
81          (1) Subsection 49-20-420(3), regarding a requirement to report to the Legislature, is
82     repealed January 1, 2030.
83          (2) Section 49-20-422, regarding coverage for pregnancy and childbirth services, is
84     repealed July 1, 2027.