Relating to Medicaid coverage and reimbursement for lactation consultation.
relating to Medicaid coverage and reimbursement for lactation
consultation.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 32.024, Human Resources Code, is
amended by amending Subsections (pp) and (qq) and by adding
Subsection (rr) to read as follows:
(pp) For purposes of enrollment as a provider and
reimbursement under the medical assistance program, the commission
shall establish a separate provider type for a community health
worker who provides lactation consultation services, or case
management services under the case management for children and
pregnant women program under Section 531.653(4), Government Code.
(qq) For purposes of enrollment as a provider and
reimbursement under the medical assistance program, the commission
shall establish a separate provider type for a doula who:
(1) is certified by a recognized national doula
certification program approved by the commission; and
(2) provides lactation consultation services, or case
management services under the case management for children and
pregnant women program under Section 531.653(5), Government Code.
(rr) The commission shall provide medical assistance
coverage of lactation consultation as a separately reimbursed
pregnancy related service when delivered to a recipient under the
medical assistance program by an eligible provider who has a
certification in lactation consultation. The executive
commissioner shall establish a separate provider type for lactation
consultant providers for purposes of enrollment as a provider for
and reimbursement under the medical assistance program.
SECTION 2. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 3. This Act takes effect September 1, 2025.
