Certified Doulas May Now Enroll in PA Medicaid

Beginning tomorrow, Pennsylvania joins 12 other U.S. states in adding coverage for doula services for people on Medicaid (also known as Medical Assistance or "MA").  Certified doulas may now enroll as providers in MA Managed Care Orgaizations' (MCOs') netwoks.  Doulas are nonclinical professionals who offer physical, emotional, and informational support during pregnancy, delivery, and post-partum. In 2022, the White House’s Blueprint for Addressing the Maternal Health Crisis supported increasing access to doula care as one critical component of addressing the maternal health crisis, especially for people on Medicaid.

In a Bulletin released earlier this month, the Department of Human Services outlines the requirements for doulas to enroll in the Medical Assistance program. Doulas will now be able to to enter into provider agreements with Medical Assistance Managed Care Organizations (MCOs) and begin serving their members. Unfortunately, doulas will not yet be covered for people enrolled in Medical Assistance Fee-for-Service (also known as ACCESS), because they are not currently identified as a distinct provider type in Pennsylvania’s Medicaid state plan.

Doulas must be certified by the Pennsylvania Certification Board as a Certified Perinatal Doula in order to enroll in the MA Program.  Information on how to become a Certified Perinatal Doula can be found on the PA Certification Board website at www.pacertboard.org/doula.  Certified doulas will be enrolled in the MA program as a Provider Type 13, which is defined as “Non-Traditional Provider.” Doulas may submit an online provider enrollment application using the Department’s secure web portal.

The enrollment of certified doulas in the MA program is another critical step Pennsylvania’s Department of Human Services is taking to improve maternal and child health for people in the MA program. PHLP applauds this development and looks forward to helping individuals seeking doula services access the care they need.