RS 1059 - Required coverage for services provided by midwives; reimbursement discrimination prohibited; definitions
A. The legislature hereby finds and affirms all of the following:
(1) Midwives are community-based practitioners who provide comprehensive, holistic, individualized maternity care and alternative birthing services to low-risk clients.
(2) Midwifery care is family-centered and individualized to consider the unique cultural, ethnic, psychosocial, nutritional, and educational needs of the client and supports healthy lifestyle habits that benefit the whole family.
(3) Midwives have made a tremendous contribution to the health and welfare of mothers and the practice of midwifery continues to advance as a profession as these providers comprise an increasing part of mainstream health care.
B.(1) Any health coverage plan delivered or issued for delivery in this state that provides benefits for maternity services shall include coverage for healthcare services provided by a midwife.
(2) The coverage provided for in this Section may be subject to annual deductibles, coinsurance, and copayments. A health coverage plan shall not differentiate between services performed by a midwife within his lawful scope of practice and services by a physician with respect to copayment or annual deductible amounts or coinsurance percentages.
C.(1) Whenever any health coverage plan delivered or issued for delivery in this state provides for reimbursement of any services which are within the lawful scope of practice of certified nurse midwives and certified professional midwives as defined in R.S. 37:3241, the insured or other person entitled to benefits under the health coverage plan shall be entitled to reimbursement for the services, whether the services are performed by a physician or a midwife.
(2) Terminology in any health coverage plan policy or contract deemed discriminatory against certified nurse midwives, certified professional midwives, or midwifery or that inhibits reimbursement for services at the in-network rate is void and unenforceable.
D. For purposes of this Section, the following definitions apply:
(1) "Health coverage plan" means any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, contract, or other agreement with a health maintenance organization or a preferred provider organization, health and accident insurance policy, or any other insurance contract of this type in this state, including a group insurance plan, a self-insurance plan, and the Office of Group Benefits programs. "Health coverage plan" does not include a plan providing coverage for excepted benefits as defined in R.S. 22:1061, limited benefit health insurance plans, and short-term policies that have a term of less than twelve months.
(2) "Midwife" means a certified nurse midwife licensed by the Louisiana State Board of Nursing in accordance with the provisions of R.S. 37:911 et seq. or a certified professional midwife licensed pursuant to the Midwife Practitioners Act, R.S. 37:3240 et seq.
Acts 2021, No. 182, §1, eff. Jan. 1, 2022.