Doula Services as a Medi-Cal Benefit
The Department of Health Care Services (DHCS) is adding doula services to the list of preventive services covered under the Medi-Cal program. Doula services include personal support to women and families throughout a woman's pregnancy, childbirth, and postpartum experience. This includes emotional and physical support, provided during pregnancy, labor, birth, and the postpartum period. Pursuant to federal regulations, doula services must be recommended by a physician or other licensed practitioner.
DHCS will add doula services as a covered benefit starting January 1, 2023. In order to add these services, DHCS must submit a State Plan Amendment (SPA) to the Centers for Medicare and Medicaid Services (CMS) and receive federal approval. Federal law allows DHCS to add "Preventive Services" to the Medi-Cal State Plan, and DHC intends to amend the State Plan to add doula services under this authority, as recommended by CMS.
In order to allow for the successful implementation of the doula benefit, DHCS adjusted the launch date from July 1, 2022, to January 1, 2023. This change is needed to allow DHCS to continue working with stakeholders to further define and develop the benefit, implement needed changes to the Provider Application and Verification for Enrollment (PAVE) system to allow doulas to enroll as Medi-Cal providers, seek and obtain federal approval, and give Medi-Cal managed care plans additional time to plan for and implement the benefit. The new effective date will also allow for a more robust stakeholder engagement process to assist DHCS with implementation.
In preparation for submitting the SPA to add doula services, DHCS is seeking input from stakeholders through virtual meetings and written comments.
The next regular stakeholder meeting will be held via Zoom/telephone from
10:00 a.m. to 12:00 p.m. Friday, July 1, 2022.
Stakeholders are encouraged to comment on the federally required elements to authorize unlicensed providers under Preventive Services of the State Plan, including the following:
- Doula qualifications to provide services, including any required education, training, experience, credentialing, and/or registration
- A description of covered services offered by doulas
- Any amount, duration, and scope limitations
DHCS will also engage with stakeholders to make recommendations on outreach efforts to notify Medi-Cal beneficiaries about doula services, among other topics.
Doula services will be available in fee-for-service Medi-Cal and through Medi-Cal managed care plans. Beneficiaries in a Medi-Cal managed care plan will receive doula services from their plan.
July 1, 2022, 10:00 a.m. to 12:00 p.m., Agenda
- May 25, 2022,
DRAFT SPA Pages Version 2
- May 16, 2022, Rate Development Process,
- April 28, 2022,
- March 29, 2022,
DRAFT SPA page
- February 15, 2022, Agenda
- November 19, 2021, (no DHCS presentation given)
- October 20, 2021, Presentation
- September 16, 2021, Presentation
Future Stakeholder Meetings*
- July 28, 2022, 2:00 to 4:00 p.m.
- August 24, 2022, 1:00 to 3:00 p.m.
- September 30, 2022, 10:00 a.m. to 12:00 p.m.
*meetings are subject to change
For questions regarding the doula services benefit, please contact DoulaBenefit@dhcs.ca.gov.