AN ACT to reduce maternal morbidity and mortality through the implementation of rate increases for obstetrics maternal bundle payments for pregnancy care and additional medicaid add‑on rates and covered services.

The General Assembly of North Carolina enacts:

SECTION 1.(a)  The Department of Health and Human Services, Division of Health Benefits (DHB), shall increase to at least seventy‑one percent (71%) of the Medicare rate the Medicaid rate paid for obstetrics maternal bundle payments for pregnancy care. This rate increase shall be implemented as soon as practicable.

SECTION 1.(b)  In order to incentivize the use of group prenatal care visits by Medicaid beneficiaries, the Department of Health and Human Services, Division of Health Benefits (DHB), shall develop an add‑on rate to the relevant capitated rates or payments that include prenatal care services. This add‑on rate shall include amounts sufficient to make payments to providers that achieve a level of Medicaid beneficiary participation in group prenatal care visits. DHB shall determine the level of patient participation required for a provider to receive these provider payments. These provider payments may be used by a provider to establish incentives for Medicaid beneficiary patients to attend group prenatal care visits. This rate increase shall be implemented as soon as practicable.

SECTION 1.(c)  DHB shall seek approval from the Centers for Medicare and Medicaid Services (CMS) to implement Medicaid coverage of certain healthcare services provided by a doula. DHB shall develop the parameters of services to be covered, including updating applicable clinical coverage policies, developing appropriate reimbursement for covered services provided by a doula, and determining provider credentialing requirements for participation in the NC Medicaid program. This coverage shall be implemented as soon as practicable upon approval by CMS. DHB shall report to the Joint Legislative Oversight Committee on Medicaid and NC Health Choice no later than March 1, 2024, regarding the details of the Medicaid coverage of healthcare services provided by a doula, the specific reimbursement for these services, and the estimated recurring cost to the State of providing this coverage.

SECTION 2.  There is appropriated from the General Fund to the Department of Health and Human Services, Division of Health Benefits, the sum of two million eight hundred thousand dollars ($2,800,000) in recurring funds for each year of the 2023‑2025 fiscal biennium to implement the Medicaid‑related changes outlined in this act. These funds shall provide a State match for five million five hundred thousand dollars ($5,500,000) in recurring federal funds for each year of the 2023‑2025 fiscal biennium, and those federal funds are appropriated to the Division of Health Benefits to pay for costs associated with the Medicaid‑related changes outlined in this act.

SECTION 3.  Section 2 of this act is effective July 1, 2023. The remainder of this act is effective when it becomes law.