Utah § 49-20-422 Coverage of pregnancy and childbirth services, including doula, direct- entry midwife, and birthing center services.

Utah Statutes

§ 49-20-422 — Coverage of pregnancy and childbirth services, including doula, direct- entry midwife, and birthing center services.

Utah·Title 49 Utah State Retirement and Insurance Benefit Act·Ch. 49-20 Public Employees' Benefit and Insurance Program Act·Part 49-20-4 Insurance Program

(1)As used in this section:

(1)(a) "Doula" means an individual who:

(1)(a)(i) provides information and physical and emotional support:

(1)(a)(i)(A) to a pregnant or postpartum individual; and

(1)(a)(i)(B) related to the pregnant or postpartum individual's pregnancy; and

(1)(a)(ii) is certified by one or more organizations approved by the program.

(1)(b) "Pregnancy and childbirth services" means services provided to a pregnant individual before, during, or shortly after childbirth:

(1)(b)(i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and

(1)(b)(ii) at a birthing center that:

(1)(b)(ii)(A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or accredited by the Commission for the Accreditation of Birth Centers; and

(1)(b)(ii)(B) may include

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(1) As used in this section:

(1)(a) "Doula" means an individual who:
(1)(a)(i) provides information and physical and emotional support:

(1)(a)(i)(A) to a pregnant or postpartum individual; and
(1)(a)(i)(B) related to the pregnant or postpartum individual's pregnancy; and
(1)(a)(ii) is certified by one or more organizations approved by the program.
(1)(b) "Pregnancy and childbirth services" means services provided to a pregnant individual before, during, or shortly after childbirth:
(1)(b)(i) by a doula for the services described in Subsections (1)(a)(i) and (ii); and
(1)(b)(ii) at a birthing center that:

(1)(b)(ii)(A) is licensed under Title 26B, Chapter 2, Licensing and Certifications, or accredited by the Commission for the Accreditation of Birth Centers; and
(1)(b)(ii)(B) may include services by a direct-entry midwife licensed under Title 58, Chapter 77, Direct-Entry Midwife Act, if the direct-entry midwife is engaged in the practice of direct-entry midwifery, as defined in Section 58-77-102.
(1)(c) "Qualified individual" means a covered individual who is:
(1)(c)(i) within the state employees' risk pool; and
(1)(c)(ii) (1)(c)(ii)(A) is pregnant; or
(1)(c)(ii)(B) was pregnant within the past six months.
(2) For a plan year that begins on or after July 1, 2023, and before July 1, 2026, the program shall cover pregnancy and childbirth services to a qualified individual.
(3) The program may establish limits for coverage under Subsection (2), including limits based on:

(3)(a) the type or number of services provided;
(3)(b) a qualified individual's physical or emotional condition; and
(3)(c) conditions for provider participation.
(4) The program shall report to the Health and Human Services Interim Committee on or before October 1 of each year regarding coverage provided under Subsection (2), including:

(4)(a) covered providers;
(4)(b) covered services;
(4)(c) provider payment rates;
(4)(d) covered-individual cost sharing;
(4)(e) total provider payments and covered-individual cost sharing; and
(4)(f) any indicators of whether pregnancy and childbirth services covered under Subsection (2) have:
(4)(f)(i) reduced pregnancy or postpartum coverage costs; or
(4)(f)(ii) improved pregnancy or postpartum care.

Utah § 49-20-422 (Coverage of pregnancy and childbirth services, including doula, direct- entry midwife, and birthing center services.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.