Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 463.000 - Doula Services › Section 463.404 - Provider Eligibility

Current through Register 1525, July 5, 2024
Payment for services described in
				130 CMR
				463.000 will only be made to doulas or doula group
				practices who are participating in MassHealth on the date of service. Doulas
				must meet the following eligibility requirements.
(A)
In-state
			 Providers
. To be eligible to participate in MassHealth, an
			 in-state doula must meet the following qualifications:
(1) be at least 18 years old;
(2) complete trainings provided by the
			 Executive Office of Health and Human Services (EOHHS) on topics including, but
			 not limited to:
(a) overview of the MassHealth
			 Doula Services Program, including best practices for meeting the needs of
			 diverse MassHealth members and their families;
(b) federal and state laws and regulations
			 established for the protection of the privacy and security of the member
			 information doulas create, use, collect, store, and/or transmit;
(c) navigating MassHealth-covered services
			 and community resources for MassHealth members; and
(3) demonstrate competency in the following
			 areas, either through the Formal Training Pathway or Experience Pathway as
			 defined in
			 130
			 CMR 463.404, subject to EOHHS review and
			 approval:
(a) basic understanding of the
			 following topics at a minimum, as those topics relate to the ability to provide
			 emotional, informational, and physical support to individuals and families
			 during the perinatal period, regardless of the outcome of the pregnancy:
1. maternal anatomy and physiology during the
			 perinatal period, including basic fetal growth and development in each
			 trimester of pregnancy;
2. common
			 medical interventions during pregnancy, childbirth, and the postpartum
			 period;
3. common potential
			 complications associated with pregnancy, childbirth, and the postpartum period
			 including, but not limited to
a. pregnancy and
			 infant loss;
b. mental health
			 conditions including Perinatal Mood and Anxiety Disorders (PMADs);
c. substance use disorder (SUD);
			 and
d. high blood
			 pressure;
4. labor and
			 delivery comfort measures;
5. best
			 practices for supporting members in advocating for their needs and making
			 informed decisions using a trauma-informed approach; and
f. basic newborn care, including the
			 fundamentals of breastfeeding/chestfeeding.
(b)
Formal Training
			 Pathway
. Provide a certificate of completion or other proof of
			 doula training(s) attended, and/or proof of doula certification by a
			 doula-certifying organization and a completed attestation form, using the
			 template provided by EOHHS, stating that the completed formal training(s)
			 covered the required competencies listed above.
(c)
Experience
			 Pathway
. Provide the following recommendations using templates
			 provided by EOHHS:
1. recommendations from at
			 least three different former clients for whom the prospective MassHealth doula
			 provided doula services (either paid or volunteer) within the last five years;
			 and
2. recommendations from at
			 least two different licensed health care providers such as physicians,
			 midwives, social workers, or nurses who observed the applicant providing doula
			 services within the last five years.