SF 3768

Introduction - 94th Legislature (2025 - 2026)

Posted on 03/06/2026 09:27 a.m.

A bill for an act
relating to health insurance; requiring health plans to cover doula services; requiring
the commissioner of commerce to defray the cost of coverage of doula services;
modifying language relating to doula services coverage in the medical assistance
program; appropriating money; amending Minnesota Statutes 2024, section
256B.0625, subdivision 28b; proposing coding for new law in Minnesota Statutes,
chapter 62Q.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62Q.5205] COVERAGE OF DOULA SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Certified doula" means a certified doula, as defined in section 148.995, of the
mother's choice.
new text end

new text begin (c) "Childbirth education and support services" means emotional and physical support
provided during pregnancy, labor, birth, and the postpartum period.
new text end

new text begin (d) "Doula services" means childbirth education and support services provided by a
certified doula.
new text end

new text begin Subd. 2. new text end

new text begin Required coverage. new text end

new text begin All health plans must cover doula services.
new text end

new text begin Subd. 3. new text end

new text begin Cost-sharing requirements. new text end

new text begin A health plan must not impose any cost-sharing
requirement on the coverage under this section, including but not limited to the following
requirements:
new text end

new text begin (1) deductible;
new text end

new text begin (2) co-payment; or
new text end

new text begin (3) coinsurance.
new text end

new text begin Subd. 4. new text end

new text begin Review and referral limitations. new text end

new text begin A health plan must not impose any review
or referral limitation on the coverage under this section, including but not limited to the
following limitations:
new text end

new text begin (1) utilization review, as defined in section 62M.02;
new text end

new text begin (2) referral requirement; or
new text end

new text begin (3) delay period.
new text end

new text begin Subd. 5. new text end

new text begin Quantity limitations. new text end

new text begin A health plan must not impose any quantity limitation
on the coverage under this section.
new text end

new text begin Subd. 6. new text end

new text begin Application. new text end

new text begin If the application of subdivision 3 before an enrollee has met their
health plan's deductible would result in: (1) health savings account ineligibility under United
States Code, title 26, section 223; or (2) catastrophic health plan ineligibility under United
States Code, title 42, section 18022(e), then subdivision 3 applies to coverage under this
section only after the enrollee has met the enrollee's health plan's deductible.
new text end

new text begin Subd. 7. new text end

new text begin Reimbursement. new text end

new text begin (a) The commissioner of commerce must reimburse health
plan companies for coverage under this section, as required by Code of Federal Regulations,
title 45, section 155.170. Reimbursement is available only for coverage that would not have
been provided by the health plan without the requirements of this section. Treatments,
services, supplies, and equipment covered by the health plan as of January 1, 2026, are
ineligible for payments under this subdivision by the commissioner of commerce.
new text end

new text begin (b) Health plan companies must report to the commissioner of commerce quantified
costs attributable to the additional benefit under this section in a format developed by the
commissioner. A health plan's coverage as of January 1, 2026, must be used by the health
plan company as the basis for determining whether coverage would not have been provided
by the health plan for purposes of this subdivision.
new text end

new text begin (c) The commissioner of commerce must evaluate submissions and make payments to
health plan companies as provided in Code of Federal Regulations, title 45, section 155.170.
new text end

new text begin Subd. 8. new text end

new text begin Appropriation. new text end

new text begin Beginning in fiscal year 2028, an amount necessary to make
payments to health plan companies to defray the cost of providing coverage under this
section is annually appropriated from the general fund to the commissioner of commerce.
The amount appropriated under this subdivision must include the administrative costs
incurred by the commissioner to make the defrayal payments.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027, and applies to all health
plans offered, issued, or sold on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2024, section 256B.0625, subdivision 28b, is amended to read:

Subd. 28b.

Doula services.

new text begin (a) new text end Medical assistance covers doula services provided by a
certified doula as defined in section 148.995, subdivision 2, of the mother's choice.

new text begin (b) Medical assistance must meet the requirements that would otherwise apply to a health
plan under section 62Q.5205, except that medical assistance is not required to comply with
any provision of section 62Q.5205, if compliance with the provision would:
new text end

new text begin (1) prevent the state from receiving federal financial participation for the coverage under
this subdivision; or
new text end

new text begin (2) result in a lower level of coverage or reduced access to coverage for medical assistance
enrollees.
new text end

new text begin (c) new text end For purposes of this section, "doula services" means childbirth education and support
services, including emotional and physical support provided during pregnancy, labor, birth,
and postpartum. The commissioner shall enroll doula agencies and individual treating doulas
to provide direct reimbursement.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2027.
new text end