Establishes coverage levels for doula services in the state medical assistance program and for health benefit plans that provide coverage for pregnancy and childbirth expenses.
SB 1568 expands and standardizes coverage for perinatal support services in Oregon, with a primary focus on doula care and lactation counseling. The bill requires the Oregon Health Authority and coordinated care organizations to ensure access to doula services for Medicaid recipients, sets minimum service levels, and bars referral or prior-authorization requirements except for additional hours based on need. It also directs the state to adopt rules defining qualification criteria for distinct perinatal doula provider types, including birth doulas and postpartum doulas, and to create a community-based perinatal services access program to support culturally specific and culturally competent services.
The bill also extends coverage requirements into the private insurance market. Health benefit plans that cover pregnancy and childbirth expenses must cover doula services and lactation counselor services, provide enrollee information on how to access those services, and generally may not impose prior authorization, referral, or supervision requirements. The bill sets a minimum coverage amount for doula services and requires future inflation adjustments, while also directing the Department of Consumer and Business Services and the Oregon Health Authority to issue implementation guidance and align coverage rules. Several provisions take effect on January 1, 2028, while the bill itself is an emergency measure effective on passage.
SB 1568 amends multiple sections of Oregon law governing Medicaid, insurance coverage, and the regulation of traditional health workers. It revises ORS 414.665, 414.668, 414.669, 676.380, 676.386, 676.665, and 743A.081; repeals ORS 414.667 and 676.671; and creates new provisions for lactation counselor registration, perinatal service grants, and the Oregon Perinatal Collaborative at Oregon Health and Science University. The bill shifts state policy toward broader access to doula and lactation support, especially for pregnant and postpartum people in the medical assistance program and in private plans covering maternity care, while also creating administrative duties for OHA and DCBS and new funding pathways for culturally specific community providers.
The bill appears to have received generally favorable support, passing both chambers with clear majorities and advancing through committee with do-pass recommendations and amendments. The vote margins suggest broad bipartisan or at least cross-faction acceptance of expanding maternal health supports, particularly for doula services and culturally responsive care. The emergency clause and delayed operative date indicate lawmakers viewed the measure as important but also requiring implementation time.
The main points of contention appear to have centered on the scope and structure of mandated coverage, provider regulation, and administrative implementation. The bill narrows and then refines earlier references to lactation counselors and lactation educators, replaces some prior language with new definitions and voluntary registration rules, and sets specific coverage limits and reimbursement review requirements. Potential concerns likely involved cost to Medicaid and insurers, the extent of prior-authorization restrictions, and how to define and supervise qualified doula and lactation counselor providers, though the recorded votes show these issues did not prevent passage.