FISCAL NOTE
Date Requested: January 16, 2026
Time Requested: 04:02 PM |
| Agency: |
Bureau for Medical Services |
|---|
| CBD Number: |
Version: |
Bill Number: |
Resolution Number: |
| 2107 |
Introduced |
SB470 |
|
|---|
| CBD Subject: |
Health |
|---|
|
FUND(S):
'0484 - BUREAU FOR MEDICAL SERVICES-POLICY AND PROGRAMMING; 8722 - CONS FEDERAL FUNDS DIV HUMAN SERVICES GEN ADMN FD
Sources of Revenue:
Other Fund General and Federal
Legislation creates:
Fiscal Note Summary
Effect this measure will have on costs and revenues of state government.
The purpose of this bill is to require doula services to be covered by Medicaid.
The Department anticipates a fiscal impact of $750,000 (state = $134,100/federal = $615,900) should this legislation pass.
Some studies have indicated that the use of a doula could result in better birth outcomes, such as fewer preterm and low birth weight infants, and reductions in cesarean sections. If this occurs, the state could realize a savings in associated costs; however, it is impossible to calculate those savings at this time.
Fiscal Note Detail
| Effect of Proposal |
Fiscal Year |
2026
Increase/Decrease
(use"-") |
2027
Increase/Decrease
(use"-") |
Fiscal Year
(Upon Full
Implementation) |
| 1. Estmated Total Cost |
0 |
750,000 |
750,000 |
| Personal Services |
0 |
0 |
0 |
| Current Expenses |
0 |
750,000 |
750,000 |
| Repairs and Alterations |
0 |
0 |
0 |
| Assets |
0 |
0 |
0 |
| Other |
0 |
0 |
0 |
| 2. Estimated Total Revenues |
0 |
0 |
0 |
Explanation of above estimates (including long-range effect):
Projected additional expense to the Department's Bureau for Medical Services is $750,000 (state = $134,100/federal = $615,900). Blended regular and expansion FMAP used = 82.12%.
Key assumptions: number of births covered by Medicaid in SFY25: 7,500 (“2025 March of Dimes Report Card for West Virginia”. Retrieved from MarchofDimes.Org), 8% of births nationwide are attended by a doula ( “The Positive Impact of Doula Care and State Regulation of Doulas and Doula Care”, N.D., The Network for Public Health Law. Retrieved from NetworkforPHL.Org), $1,000 flat rate for birth and delivery, plus 2 prenatal and 2 postpartum visits, $125 rate per visit for 2 additional visits (up to 4 are allowed, but assume only 2 will be used). Under these assumptions: 1) the state will reimburse $1,250 per member for doula services under Medicaid (125*2) + 1,000 = $1,250; 2) the annual fiscal impact would be $750,000 ($1,250*(8%*7,500) = $750,000.
Estimate does not account for additional administrative expenses for implementation and continued coverage as well as potential savings.
Memorandum
Estimate does not account for additional administrative expenses for implementation and continued coverage as well as potential savings.
Other states have submitted Medicaid state plan amendments to the U.S. Centers for Medicare and Medicaid Services and received approval to allow for reimbursements for doula services. Assuming West Virginia also received approval, the federal government would likely reimburse the appropriate federal match for both Medicaid and CHIP.
Person submitting Fiscal Note: Alex J. Mayer, MSA, PMP, DoHS Cabinet Secretary
Email Address: osafiscalnotes@wv.gov