Senate Government Operations Committee agrees to concur with House changes on S.53 doula Medicaid timeline

The Senate Government Operations Committee agreed on May 22 to concur with amendments the Vermont House added to S.53, a bill setting up Medicaid payment for certified community doulas, after House Health Care members and agency staff described timing and implementation constraints.

The House amendment delays certain implementation dates to give the Office of Professional Regulation (OPR) and the Medicaid agency more time to complete certification rulemaking, to update the Medicaid Management Information System (MMIS) and to pursue a state plan amendment with the federal Centers for Medicare & Medicaid Services (CMS). Representative Marie Geporius, who reported the House committee’s work to the Senate committee, said the amendment “provides DVHA more time to address concerns” about MMIS changes, the state plan amendment process and OPR rulemaking.

Why it matters: The amendment does not change the policy goal — reimbursing certified community doulas through Medicaid — but it delays deadlines so state agencies can complete required administrative steps before Medicaid payments begin. Committee members said the delay avoids forcing agencies into rushed rulemaking or MMIS changes that could take a year or longer.

Discussion details: Republican and Democratic senators asked whether the Department of Health and Human Services or other relevant offices had reviewed the House changes. Legislative counsel Jim Carvey told the committee the bill was before the Senate on notice as a House proposal and that any Senate committee that had previously reviewed the bill could take a position and report a recommendation to the full Senate when the bill comes up on the floor.

Representative Marie Geporius summarized concerns raised in House Health Care: lack of an immediate appropriation for Medicaid payments to doulas; the time required for OPR’s certification rulemaking; anticipated MMIS work required to add a new Medicaid service; and the need to secure CMS approval via a state plan amendment. She said the House amendment was designed to give the Medicaid agency and OPR adequate time to complete the administrative and federal-approval steps before payments are implemented.

OPR comment: A speaker identifying herself as Sarah from OPR said OPR “fully support[s] the doula bill as it passed out of the house” and welcomed the additional time the amendment provides for regulatory work.

Committee action and next steps: The committee asked whether any member objected to concurring with the House amendment; none objected and the committee agreed to concur and to report a recommendation to the full Senate when the matter is on the Senate calendar. Senate staff said they will confirm alignment with the Senate Health and Welfare committee and speak with relevant Senate members on the floor if needed.

Implementation notes and limitations: Committee members emphasized that certification is required for doulas to receive Medicaid payments; persons providing doula services without certification can continue to work but would not be reimbursed by Medicaid. Representative Geporius and legislative counsel noted that the state plan amendment process can be lengthy and that other states have added doula services to Medicaid via state plan amendments. The amendment therefore focuses on timing rather than changing the Medicaid coverage requirement.

No appropriation detail was finalized during the committee meeting; members said funding and reimbursement rates would be addressed later in the legislative or agency budgeting process.