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HB 1464

A BILL for an Act to provide for a legislative management study relating to maternal care services.

69th Legislative Assembly (2025-26) Introduced by Karen Anderson and 9 co-sponsors

Directs a 2025-26 interim study of North Dakota maternal care services, funded by a $200,000 DHHS contract, to assess access, providers, coverage, and potential reforms.

Second reading, failed to pass, yeas 19 nays 26
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Bill Summary · HB 1464

Summary — HB 1464

A BILL for an Act to provide for a legislative management study relating to maternal care services

Main purpose / intent

HB 1464 would direct the North Dakota Legislative Management to carry out a comprehensive interim study (2025–26) of maternal care services in the state and fund consulting support for that study. Earlier committee versions of the bill also included provisions to establish postpartum doula certification and, in some drafts, medical-assistance coverage for postpartum doula services; however, the primary final-engrossed language centers on the legislative-management study and a one-time appropriation to support it.

Key provisions

  • Legislative management study (2025–26 interim)

    • Required topics to be examined:
    • Availability and utilization of medical and nonmedical prenatal services by community and geographic area.
    • Childbirth service availability (in-home and facility-based) and counts of obstetrician–gynecologists and family practitioners who routinely deliver babies by area.
    • Review of prenatal, childbirth, and postnatal services covered by public assistance, private insurance, and pregnancy resource centers (including funding, program evaluation, and outcomes).
    • Consideration of prior studies and existing maternal care resource/asset maps; identification of service gaps and evidence-based or pilot solutions to close gaps.
    • Approaches to increase utilization of prenatal/postnatal services.
    • Evaluation of ways to increase the number of practicing OB‑GYNs and family practitioners in the state.
    • Exploration of processes for certifying, training, and reimbursing doula and midwife services.
    • Consideration of public-assistance and private-insurance policy options to improve maternal and infant health outcomes.
    • Solicitation of input from specified stakeholders (e.g., UND School of Medicine & Health Sciences, maternal/infant mortality review panels, Foundation for a Healthy North Dakota, doulas and midwives, ND medical association, WIC, North Dakota Health Tracks).
    • Requirement: legislative management must report findings, recommendations, and any implementing legislation to the Seventieth Legislative Assembly.

  • Postpartum doula certification (committee language present in earlier drafts)

    • Directed the Department of Health and Human Services (DHHS) to designate acceptable doula-certifying organizations, adopt implementation rules, maintain a list of designated organizations, and not impose additional state certification fees beyond those charged by designated organizations.
    • Some committee versions also would have required Medicaid/medical assistance coverage for postpartum doula services; that coverage provision appears in some earlier committee drafts but is not the central feature of the final-engrossed study/appropriation version.

  • Appropriation

    • One-time appropriation of $200,000 from the general fund to DHHS for contracting consulting services with a public‑health program in the North Dakota higher‑education system to support the maternal care services study.
    • Appropriation covers the biennium beginning July 1, 2025 and ending June 30, 2027; designated as one-time funding.

Who would be affected

  • State agencies: Department of Health and Human Services (implementation support, rulemaking if certification language adopted), Legislative Management (study).
  • Health providers and workforce: doulas, midwives, obstetricians, family practitioners, and other prenatal/postnatal service providers (subject of study; potential future certification, reimbursement or coverage changes).
  • Insurers and public-assistance programs: possible policy recommendations affecting coverage and reimbursement for maternal/infant services.
  • Higher‑education public‑health program(s): potential contractor(s) to perform study work funded by the $200,000 appropriation.

Fiscal and procedural notes

  • Fiscal: one-time General Fund appropriation of $200,000 to DHHS to contract for consulting services; no ongoing appropriation in the bill text. Other versions that would add Medicaid coverage could carry additional fiscal implications (not quantified in the study text).
  • Timeline: study conducted during the 2025–26 interim; report and any recommended legislation due to the Seventieth Legislative Assembly.
  • Status: The bill was considered by committees and amended in various forms (including postpartum doula certification and medical‑assistance coverage in committee drafts). On second reading the measure failed to pass (vote recorded as yeas 19, nays 26) and subsequently did not become law at sine die adjournment. Some companion or related drafts and amendments circulated through committee reports during 2025.

Compiled from official sources — confirm details with the bill’s official record.

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