nh-2026-215: Doula Services

1. Agency: Department of Health and Human Services

Agency Address: Department of Health and Human Services Division of Medicaid Services 129 Pleasant Street, Brown Bldg. Concord, NH 03301

6. (a) Summary of what the rule says and of any proposed amendments including

whether the rule implements a state statute for the first time: He-W 545 specifies who is covered for doula services, the scope and limitation of coverage for those services, provider requirements, payment information, and provides for departmental monitoring for the utilization of Medicaid covered doula services. This proposed rule has been made in compliance with RSA 126-A:99, V, (Chapter 79 of the Laws of 2023), which went into effect on July 1, 2023. The Department of Health and Human Services (Department) is proposing to adopt He- W 545. The new rule includes: • Definitions of important terms used throughout the rule; • Descriptions of who is eligible to receive care through this program; • Descriptions of the requirements for providers seeking to provide care through this program; ADMINISTRATIVE RULES (603) 271-3680 Generated on 10/05/2026 • Descriptions of the manner as to how prenatal andpostpartum services arerequired to be allocated; • Descriptions of the types of services covered by this program; • An establishment of control procedures to prevent waste, fraud, and abuse; • An establishment of a requirement to exhaust third party billing options prior to Medicaid billing; • An establishment of the manner and mode for providers to submit claims for reimbursement; and • An establishment of record keeping requirements. X Does this rule implement a state statute for the first time? If yes, please explain: This rule is being adopted pursuant to RSA 126-A:99, V, (Chapter 79 of the Laws of 2023), effective July 1, 2023. 6. (b) Brief description of the groups affected: This rule affects Medicaid recipients who are eligible for doula services in the fee for service program, and the Medicaid enrolled providers, namely doulas, who provide these services. 6. (c) Specific section or sections of state statute or federal statute or regulation which the rule is intended to implement: Specific State or Federal Statute or Regulations the Rule Rule Implements He-W 545.01 RSA 161:4-a, X He-W 545.02 RSA 126-A:99 He-W 545.03 42 CFR 440.210; 42 CFR 440.220 He-W 545.04 42 CFR 440.210; 42 CFR 440.220 He-W 545.05 RSA 126-A:99; 42 CFR 440.210; 42 CFR 440.220 He-W 545.06 42 CFR 455; 42 CFR 456 He-W 545.07 42 CFR 433.139 He-W 545.08 RSA 161:4, VI; 42 CFR 447 Subpart B ADMINISTRATIVE RULES (603) 271-3680 Generated on 10/05/2026

7. Contact person for copies and questions including requests to accommodate

persons with disabilities: Name: Allyson Raadmae Title: Administrator- Administrative Rules Unit Address: Dept. of Health and Human Services Administrative Rules Unit Phone Number: (603) 271-9604 129 Pleasant Street, 2nd Floor Concord, NH 03301 FAX Number: (603) 271-5590 Email: Allyson.E.Raadmae@dhhs.nh.gov

8. Deadline for submission of materials in writing or, if practicable for the agency, in

the electronic format specified: Wednesday, November 18, 2026 X Fax X Email at allyson.e.raadmae@dhhs.nh.gov _ Other

9. Public hearing scheduled for:

Date: Tuesday, November 10, 2026 Time: 11:00 AM Place: DHHS Brown Building, Auditorium, 129 Pleasant Street, Concord, NH 03301 Electronic Access, if applicable: N/A

10. Fiscal Impact Statement (Prepared by Legislative Budget Assistant):

FIS #: 26:203, dated: Tuesday, September 22, 2026

2. Cite the Federal mandate. Identify the impact on state funds:

No federal mandate, no impact on state funds.

3. Cost and benefits of the proposed rule(s):

Any cost or benefit is attributable not to the rules themselves, but to RSA 126-A:99, which mandates Medicaid coverage of doula services.

A. To State general or State special funds:

None. ADMINISTRATIVE RULES (603) 271-3680 Generated on 10/05/2026

C. To independently owned businesses:

None. 11. Statement Relative to Part I, Article 28-a of the N.H. Constitution: The proposed rule modifies an existing program or responsibility, but does not mandate any fees, duties, or expenditures on the political subdivisions of the state, and therefore does not violate Part I, Article 28-a of the N.H. Constitution. ADMINISTRATIVE RULES (603) 271-3680 Generated on 10/05/2026