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HB 2423

MEDICAID-MATERNAL HLTH-DOULAS

104th Regular Session Introduced by Dee Avelar and 33 co-sponsors

Illinois hospitals must allow Medicaid-certified doulas for Medicaid patients before, during, and after birth, with policies, liaison, and doula certification verification.

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Bill Summary · HB 2423

Summary — HB 2423 (Illinois) — Medicaid: Maternal Health / Doulas

Status: Placed on Calendar Order of 3rd Reading (Oct 15, 2025)
Introduced: Feb 4, 2025
Primary House sponsor: Rep. Yolonda Morris; Primary Senate sponsor: Sen. Don Harmon
Adds Sections 5‑18.6 and 5‑18.7 to the Illinois Public Aid Code (305 ILCS 5)

Purpose

To increase access to doula support for persons enrolled in Illinois Medicaid by requiring hospitals and birthing centers to permit a Medicaid‑certified and enrolled doula chosen by the patient to accompany and support the patient before, during, and after labor and childbirth, and to establish state guidance mechanisms to support access to maternal and reproductive preventive services.

Key provisions

  • Facility policies (Sec. 5‑18.6)

    • All hospitals with licensed obstetric beds and birthing centers must adopt and maintain written policies/procedures allowing a patient enrolled in the medical assistance (Medicaid) program to have an Illinois Medicaid‑certified and enrolled doula accompany the patient on facility premises to provide support before, during, and after labor and childbirth.
    • In the engrossed version, facilities must adopt these policies within 6 months after the amendatory act takes effect.
    • An Illinois Medicaid‑certified and enrolled doula:
    • May not be counted as a “support person” or counted against any guest quota.
    • Is considered part of the patient’s care team (policy language emphasizes support/advocacy role).
    • Facilities must:
    • Post a summary of the policy on the facility website, including contact information to facilitate communication with Medicaid doulas and doula organizations.
    • Provide copies of the policy (electronically or otherwise) to maternity healthcare providers and to patients (in some versions, provided prior to presenting for delivery).
    • Designate a staff liaison to communicate with Medicaid‑enrolled doulas/organizations.
    • At the facility’s request, doulas must provide written proof/acknowledgment of Illinois Medicaid certification and enrollment.
    • Hospitals are not liable solely because they permitted a Medicaid‑certified doula to accompany a patient; hospitals and doulas remain responsible for their own acts/omissions. The bill does not alter existing malpractice liability limits.
  • Patient/doula notification (House floor amendment)

    • The patient (or delivery provider/representative) must notify the facility per the facility’s policy before delivery; notification should include the doula’s name and proof of certification/enrollment.
  • State standing recommendations (Sec. 5‑18.7)

    • The Department of Healthcare and Family Services and the Department of Public Health may establish standing recommendations to meet CMS requirements and to ensure access to preventive services (including Medicaid‑covered maternal/reproductive supports such as doulas, lactation consultants, home visitors, community health workers, and services under 1115 waivers).
    • Employees issuing such standing recommendations are shielded from disciplinary, civil, or criminal liability arising from those acts/omissions.

Who is affected

  • Medicaid‑enrolled pregnant persons receiving maternity care in Illinois hospitals and birthing centers (increased access to doula support).
  • Hospitals and birthing centers (must create/adopt policies, post summaries online, designate liaisons, accept doula documentation).
  • Doulas (must be Illinois Medicaid‑certified and enrolled; may provide support without counting against guest quotas).
  • State health agencies (may issue standing recommendations and coordinate implementation).

Procedural/timeline notes

  • House actions: Filed Feb 4, 2025; passed House (3rd reading) Apr 10, 2025 (112–0) with floor amendments; multiple co‑sponsors added.
  • Senate actions: Arrived in Senate Apr 14, 2025; assigned to committee and to Executive; Senate Committee Amendment No. 1 filed May 13, 2025; amendment adopted May 14; placed on calendar for 3rd reading Oct 15, 2025.
  • Compliance deadline: Engrossed text requires facilities to adopt policies within 6 months after the amendatory act (where specified).

Potential impacts

  • Likely to expand practical access to doula services for Medicaid beneficiaries, which advocates associate with improved birth outcomes and patient satisfaction.
  • Imposes administrative obligations on facilities (policy creation, posting, liaison role, handling doula verification).
  • Clarifies liability boundaries between hospitals and doulas and provides state agencies authority to issue implementation guidance aligned with CMS rules.

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

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