The Acting Director of the Defense Health Agency (DHA) is notifying the public of modifications to the reimbursement of certified labor doulas (CLDs) performing childbirth support services under the Childbirth and Breastfeeding Support Demonstration (CBSD). This notice announces changes to the reimbursement methodology for childbirth support services intended to stabilize reimbursement of CLDs. To prevent TRICARE rates from falling below Medicaid reimbursement, ( printed page 3871) the DHA Director, or designee, will approve a new baseline if it is found that TRICARE reimbursement is not keeping pace with Medicaid reimbursement. In other words, this change will ensure that childbirth support services rates will not decrease and that increases will be reasonably indexed to rates nationwide. The modification to the reimbursement methodology for childbirth support services will result in annual incremental costs of about $280,000.00.