New York State Medicaid Doula Services Benefit

The NYS enacted 2023-24 Executive Budget includes expanded Medicaid coverage of preventative care, including Statewide Medicaid coverage and higher reimbursement for doulas. The NYS Office of Health Insurance Programs will engage doula stakeholders to develop and implement the Medicaid doula services benefit.

Doula Stakeholder Meetings

Upcoming Virtual Town Halls

2024 Tentative Public Meeting Dates*
Date Time Registration Link Slide Deck Recording
Tuesday, January 9, 2024 10:00am-12:00pm Concluded PDF YouTube
Tuesday, February 13, 2024 10:00am-12:00pm Concluded PDF  
Tuesday, March 12, 2024 10:00am-12:00pm Register Here    
Tuesday, April 9, 2024 10:00am-12:00pm Register Here    
Tuesday, May 14, 2024 10:00am-12:00pm      
Tuesday, June 11, 2024 10:00am-12:00pm      
Tuesday, July 9, 2024 10:00am-12:00pm      
Tuesday, August 13, 2024 10:00am-12:00pm      
Tuesday, September 10, 2024 10:00am-12:00pm      
Tuesday, October 8, 2024 10:00am-12:00pm      
Tuesday, November 12, 2024 10:00am-12:00pm      
Tuesday, December 10, 2024 10:00am-12:00pm      

*Additional meetings to support provider enrollment may be added.

Date Time Slide Deck Recording
Tuesday, May 30, 2023 1:00pm-2:00pm PDF YouTube
Tuesday, June 20, 2023 2:00pm-4:00pm PDF YouTube
Friday, July 7, 2023 9:00am - 11:00am PDF YouTube
Monday, July 17, 2023 11:00am-1:00pm PDF YouTube
Friday, August 11, 2023 10:00am-12:00pm PDF | Pilot YouTube
Friday, September 22, 2023 10:00am-12:00pm PDF YouTube
Monday, October 16, 2023 2:00pm-3:00pm PDF YouTube
Thursday, November 16, 2023 9:00am-10:00am PDF | CDPHP YouTube
Friday, December 1, 2023 9:30am-10:30am PDF | IH YouTube

Doula Services Statewide Implementation Updates

The proposed State Plan Amendment (SPA) for NYS Medicaid Doula Services was submitted for federal approval on December 28, 2023. There are two ways to view the proposed SPA:

  1. Visit the Proposed and Approved State Plan Amendments website.
    • Open the year 2024
    • Click 'on-Institutional Services'
    • Find SPA 24-03, Doula Services, and click the link under the column "Original Submission"
  2. Link to SPA 24-03

The Federal Public Notice (FPN) for doula services was published in the NYS Register as of December 13, 2023. The FPN allows for formal public comment on the proposed NYS Medicaid doula services benefit from the FPN publication date, December 13, 2023, until federal approval. There are three ways to view the FPN:

  1. Link to the Dec 13, 2023, NYS Register (page 79 of the document, page 85 of the PDF).
  2. Visit the State Register website.
    • The doula services FPN can be found in the issue labeled "December 13, 2023/Vol. XLV, Issue 50.".
    • To review issues, scroll down to the bottom of the State Register website and use the search function.
  3. View the PDF of the Dec 13, 2023, NYS Register (page 79 of the document, page 85 of the PDF).

Doula Services Statewide Enrollment Information

Provider Enrollment Feedback Sessions

On January 12 and January 17, 2024, NYS Medicaid hosted two one-hour, virtual sessions with 22 stakeholders who volunteered to provide feedback about the Medicaid enrollment process for doulas. Stakeholders provided their perspectives about strengths, weaknesses, and suggestions for the Erie County doula pilot enrollment materials and draft provider enrollment materials for the upcoming statewide benefit for doula services. NYS Medicaid thanks all participants for their time and feedback to improve the enrollment process.

A summary of the feedback can be found in the table below.

Date Time Registration Link Slide Deck Summary
Friday, January 12, 2024 1:00pm-2:00pm Concluded PDF PDF
Wednesday, January 17, 2024 12:00pm-1:00pm Concluded PDF PDF



Doulas cannot enroll yet as Medicaid providers for the statewide benefit, however, doulas can take steps now to prepare for enrollment as a Medicaid doula services provider.

Apply for a National Provider Identifier (NPI):
Review the Information on the NYS Medicaid Doula Services Benefit Website:
  • Review past Town Hall slide decks and recordings above, including the 2023 Virtual Town Hall Archive.
  • Review Frequently Asked Questions below.
Subscribe to Medicaid Updates:
  • All formal announcements, effective dates, and updates to the NYS Medicaid doula services will be published via Medicaid Updates.
  • All NYS Medicaid doula services providers will be expected to follow updated guidance.
  • To subscribe, email: medicaidupdate@health.ny.gov.
Review Doula Pilot Guidance:
  • Review guidance on the doula pilot to get familiar with eMedNY and process for NYS Medicaid provider enrollment.
  • Note: This guidance will be updated for the statewide benefit and is to be reviewed as a reference only.

  • FAQs is also available in Portable Document Format (PDF)

1. What is the projected implementation timeline for the New York State Medicaid doula services benefit?

The target implementation date for coverage of doula services under New York State Medicaid is January 1, 2024. A Medicaid State Plan Amendment (SPA) is required, and implementation of this new benefit is pending approval of the SPA from the federal Centers for Medicare & Medicaid Services (CMS).

Timeline to Statewide Implementation
2. What is a Medicaid State Plan Amendment (SPA) and why is it needed for doula services to be covered by Medicaid in New York?

The Medicaid State Plan is the official agreement between New York and the Federal government describing how New York administers its Medicaid program. The Medicaid State Plan defines groups of individuals to be covered, services to be provided, and methods for providers to be reimbursed. When a state is making a change to the Medicaid program policies or operations, a SPA must be submitted to CMS for review and approval.

3. When will doulas be able to receive reimbursement through New York State Medicaid for providing services to Medicaid-enrolled individuals?

Doulas will need to enroll as New York State Medicaid providers. At this time, only doulas who have participated in the Doula Services Pilot in Erie County have been able to enroll as New York State Medicaid providers, and enrollment is not yet open to additional doulas.

Medicaid provider enrollment will begin when the statewide policy is final and approved, and reimbursement for doula services will be available after the federal approval of the SPA.

A Medicaid Update will be published to announce the start date of availability of Medicaid reimbursement for doulas services provided by Medicaid-enrolled doulas. Medicaid Updates are published here.

4. What is the process for a doula to enroll as a provider with New York State Medicaid?

Doulas will first have to enroll with the New York State administered Medicaid program, "Medicaid fee-for-service (FFS)". Once enrolled as a Medicaid provider, a doula can then reach out to Medicaid Managed Care Organizations (MCOs) to apply to join the MCO's doula provider network. Most New York State Medicaid enrollees are members of (covered by) Medicaid MCOs. To be reimbursed for services provided to a Medicaid MCO member, a doula must be in the provider network of the MCO.

5. How are doulas being engaged in the New York State Medicaid doula services planning and design processes?

The NYS Medicaid team is hosting a series of virtual Medicaid Doula Town Hall meetings to discuss proposals for the doula services benefit and receive feedback and input from doulas and doula stakeholders. Doulas from the Medicaid Doula Services Pilot program in Erie County, as well as individual doulas, doula organizations, and doula advocates across the state have offered support, guidance, and information in the development of the benefit. A comprehensive evaluation of the Medicaid Doula Services Pilot program is being completed and findings will be considered in the design and planning for the benefit.

6. How can I participate?

To register for upcoming virtual Medicaid Doula Town Hall meetings, visit this website. Recordings and presentations from previous Town Hall meetings are also available at this link. The meetings are two hours long and held at various times of day and days of the week to accommodate different schedules. If you can't attend, you can send feedback to doulapilot@health.ny.gov.

Pilot

  1. Where can we find more information about the New York Medicaid Doula Pilot program?

To learn more about the Medicaid Doula Pilot program in Erie County, including eligibility, scope of services, enrollment, and evaluation, please visit this website.

Last updated October 2023


Doula Pilot Program

For information about the NYS Doula Pilot Program, visit New York State Doula Pilot Program.

To receive updates on the Medicaid doula services benefit, email DoulaPilot@health.ny.gov