Establishes a 14 member doula Medicaid reimbursement work group within the department of health to set reimbursement rates for doulas in the state Medicaid program and address other criteria related to their practice; requires the work group to conduct a study and evaluate the costs, benefits and issues that may be associated with Medicaid reimbursement for doulas and for providing doula care to Medicaid recipients; makes related provisions.
S09868 would create a 14-member doula Medicaid reimbursement work group within the New York State Department of Health. The group would be tasked with studying how doulas can be integrated into the Medicaid system and recommending best practices for reimbursement, program design, and related policy changes. Its membership would be majority doulas and maternal health experts, with representation from the insurance industry and appointments by the governor, Senate, and Assembly leadership.
The work group would evaluate the costs, benefits, and implementation issues associated with Medicaid coverage for doula services. Its review would include evidence-based impacts on maternal and infant mortality, examples from other states, reimbursement criteria for primary and substitute doulas, the appropriate number of antepartum, intrapartum, and postpartum visits, liability coverage, continuing education, and whether New York should amend its Medicaid state plan to pay for doula services. The group would have to report its findings and recommendations by December 31, 2026.
The bill does not immediately change Medicaid reimbursement rates or require coverage, but it creates a formal state process to study and recommend those changes. If implemented, its recommendations could lead to amendments to the Medicaid state plan and new reimbursement rules for doula services, affecting the Department of Health, Medicaid managed care and fee-for-service administration, doulas, birthing people, and insurers. It also establishes expense reimbursement for work group members to support participation by historically excluded communities.
The bill appears generally supportive of expanding access to doula care and improving maternal health outcomes, with an emphasis on equity, representation, and compensation for a historically excluded workforce. The structure of the work group suggests a policy-oriented, collaborative approach rather than immediate regulatory change. No votes or committee debate were provided, so there is no recorded opposition or formal sentiment from legislative action in the materials supplied.
The main policy questions embedded in the bill concern how much Medicaid should pay for doula services, what services and visit types should qualify for reimbursement, and whether the state should require substitute doula coverage, liability insurance, and continuing education. Another likely point of tension is the inclusion of an insurance-industry representative alongside a majority of doulas and maternal health experts, reflecting a balance between provider advocacy and payer concerns. Because the bill only creates a study group, any future contention would likely arise when specific reimbursement rates and Medicaid coverage rules are proposed.