The Department of Public Health and Social Services will be amending the Guam Medicaid State Plan to pregnant and post-partum women to avail of doula services.
Doula services coverage under Medicaid would be effective for dates of services received on or after July 1, allowing reimbursement from the date of confirmed pregnancy through 180 days or six months after the end of pregnancy, DPHSS officials said on June 26.
DPHSS however said, Medicaid enrollment must be maintained during this period for prenatal and/or postpartum doula services and doula support at labor and delivery to be covered.
DPHSS said Medicaid covered doula services reimbursements for delivery and "each visit" will be billed and reimbursed separately.
"Visits are reimbursed in fifteen (15) minute increments, or units, and limited to 28 units total per pregnancy. Support at labor and delivery is limited to one unit," DPHSS officials said.
According to DPHSS, multiple births, for example delivering twins, will not result in "additional" reimbursements. Travel time and mileage incurred by the doula are also not "separately" reimbursable.
Rates for prenatal and postpartum services and labor and delivery support are the same for government and private providers of doula services, the amendment states.
DPHSS said the rates were developed "through benchmarking against comparable Medicaid fee schedules and tailored to help ensure that rates were sufficient for provider participation."
DPHSS estimated the annual aggregate cost for Medicaid-covered doula services for the first 12 months to be $186,876.
The amendment states to qualify for doula services coverage a recommendation by a physician or other licensed practitioner of the healing arts is required.
Doula services covered under the amendment include:
- Perinatal counseling and evidence-based education, to include infant care and adverse outcome prevention.
- Labor support and attendance at delivery along with the development of a birthing plan
- Coordination with community-based services to improve birth outcomes
- Visits to provide basic infant care
- Accompanying the pregnant individual to clinician visits
- Lactation support
- Emotional and physical support
"Doulas are trained to provide personal, non-medical emotional, physical, and informational support and advocacy to pregnant and postpartum individuals and their families throughout pregnancy, childbirth, and postpartum periods," DPHSS said.