[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6137 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 6137

To require the Secretary of Health and Human Services to establish and 
  implement a Perinatal Care Alternative Payment Model Demonstration 
                    Project, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2020

Ms. Schakowsky (for herself, Ms. Underwood, Ms. Adams, Ms. Scanlon, Ms. 
  Norton, Ms. Sewell of Alabama, Mr. Khanna, Ms. Bass, Ms. Moore, Mr. 
Clay, Mr. Lawson of Florida, and Ms. Pressley) introduced the following 
    bill; which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To require the Secretary of Health and Human Services to establish and 
  implement a Perinatal Care Alternative Payment Model Demonstration 
                    Project, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Innovative Maternal Payment And 
Coverage To Save Moms Act'' or the ``IMPACT to Save Moms Act of 2020''.

SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION PROJECT.

    (a) In General.--For the period of fiscal years 2022 through 2026, 
the Secretary of Health and Human Services (referred to in this section 
as the ``Secretary''), acting through the Administrator of the Centers 
for Medicare & Medicaid Services, shall establish and implement, in 
accordance with the requirements of this section, a demonstration 
project, to be known as the Perinatal Care Alternative Payment Model 
Demonstration Project (referred to in this section as the 
``Demonstration Project''), for purposes of allowing States to test 
payment models under their State plans under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) and State child health plans 
under title XXI of such Act (42 U.S.C. 1397aa et seq.) with respect to 
maternity care provided to pregnant and postpartum women enrolled in 
such State plans and State child health plans.
    (b) Coordination.--In establishing the Demonstration Project, the 
Secretary shall coordinate with stakeholders such as--
            (1) State Medicaid programs;
            (2) relevant organizations representing maternal health 
        care providers;
            (3) relevant organizations representing patients, with a 
        particular focus on women from demographic groups with 
        disproportionate rates of adverse maternal health outcomes;
            (4) relevant community-based organizations, particularly 
        organizations that seek to improve maternal health outcomes for 
        women from demographic groups with disproportionate rates of 
        adverse maternal health outcomes;
            (5) non-clinical perinatal health workers such as doulas, 
        community health workers, peer supporters, certified lactation 
        consultants, nutritionists and dieticians, social workers, home 
        visitors, and navigators;
            (6) relevant health insurance issuers;
            (7) hospitals, health systems, freestanding birth centers 
        (as such term is defined in paragraph (3)(B) of section 1905(l) 
        of the Social Security Act (42 U.S.C. 1396d(l))), federally 
        qualified health centers (as such term is defined in paragraph 
        (2)(B) of such section), and rural health clinics (as such term 
        is defined in section 1861(aa) of such Act (42 U.S.C. 
        1395x(aa)));
            (8) researchers and policy experts in fields related to 
        maternity care payment models; and
            (9) any other stakeholders as the Secretary determines 
        appropriate, with a particular focus on stakeholders from 
        demographic groups with disproportionate rates of adverse 
        maternal health outcomes.
    (c) Considerations.--In establishing the Demonstration Project, the 
Secretary shall consider each of the following:
            (1) Findings from any evaluations of the Strong Start for 
        Mothers and Newborns initiative carried out by the Centers for 
        Medicare & Medicaid Services, the Health Resources and Services 
        Administration, and the Administration on Children and 
        Families.
            (2) Any alternative payment model that--
                    (A) is designed to improve maternal health outcomes 
                for racial and ethnic groups with disproportionate 
                rates of adverse maternal health outcomes;
                    (B) includes methods for stratifying patients by 
                pregnancy risk level and, as appropriate, adjusting 
                payments under such model to take into account 
                pregnancy risk level;
                    (C) establishes evidence-based quality metrics for 
                such payments;
                    (D) includes consideration of non-hospital birth 
                settings such as freestanding birth centers (as so 
                defined);
                    (E) includes consideration of social determinants 
                of health that are relevant to maternal health outcomes 
                such as housing, transportation, nutrition, and other 
                non-clinical factors that influence maternal health 
                outcomes; or
                    (F) includes diverse maternity care teams that 
                include--
                            (i) maternity care providers, including 
                        obstetrician-gynecologists, family physicians, 
                        physician assistants, midwives who meet, at a 
                        minimum, the international definition of the 
                        term ``midwife'' and global standards for 
                        midwifery education (as established by the 
                        International Confederation of Midwives), and 
                        nurse practitioners--
                                    (I) from racially, ethnically, and 
                                professionally diverse backgrounds;
                                    (II) with experience practicing in 
                                racially and ethnically diverse 
                                communities; or
                                    (III) who have undergone trainings 
                                on racism, implicit bias, and explicit 
                                bias; and
                            (ii) non-clinical perinatal health workers 
                        such as doulas, community health workers, peer 
                        supporters, certified lactation consultants, 
                        nutritionists and dieticians, social workers, 
                        home visitors, and navigators.
    (d) Eligibility.--To be eligible to participate in the 
Demonstration Project, a State shall submit an application to the 
Secretary at such time, in such manner, and containing such information 
as the Secretary may require.
    (e) Evaluation.--The Secretary shall conduct an evaluation of the 
Demonstration Project to determine the impact of the Demonstration 
Project on--
            (1) maternal health outcomes, with data stratified by race, 
        ethnicity, socioeconomic indicators, and any other factors as 
        the Secretary determines appropriate;
            (2) spending on maternity care by States participating in 
        the Demonstration Project;
            (3) to the extent practicable, subjective measures of 
        patient experience; and
            (4) any other areas of assessment that the Secretary 
        determines relevant.
    (f) Report.--Not later than one year after the completion or 
termination date of the Demonstration Project, the Secretary shall 
submit to the Committee on Energy and Commerce, the Committee on Ways 
and Means, and the Committee on Education and Labor of the House of 
Representatives and the Committee on Finance and the Committee on 
Health, Education, Labor, and Pensions of the Senate, and make publicly 
available, a report containing--
            (1) the results of any evaluation conducted under 
        subsection (e); and
            (2) a recommendation regarding whether the Demonstration 
        Project should be continued after fiscal year 2026 and expanded 
        on a national basis.
    (g) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
    (h) Definitions.--In this section:
            (1) Alternative payment model.--The term ``alternative 
        payment model'' has the meaning given such term in section 
        1833(z)(3)(C) of the Social Security Act (42 U.S.C. 
        1395l(z)(3)(C)).
            (2) Perinatal.--The term ``perinatal'' means the period 
        beginning on the day a woman becomes pregnant and ending on the 
        last day of the 1-year period beginning on the last day of such 
        woman's pregnancy.

SEC. 3. MACPAC REPORT.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Medicaid and CHIP Payment and Access 
Commission shall publish a report on issues relating to the continuity 
of coverage under State plans under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) and State child health plans under title 
XXI of such Act (42 U.S.C. 1397aa et seq.) for pregnant and postpartum 
women. Such report shall, at a minimum, include the following:
            (1) An assessment of any existing policies under such State 
        plans and such State child health plans regarding presumptive 
        eligibility for pregnant women while their application for 
        enrollment in such a State plan or such a State child health 
        plan is being processed.
            (2) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        ensure continuity of coverage under such a State plan or such a 
        State child health plan for pregnant and postpartum women, 
        including such women who need to change their health insurance 
        coverage during their pregnancy or the postpartum period 
        following their pregnancy.
            (3) An assessment of any existing policies under such State 
        plans and such State child health plans regarding measures to 
        automatically reenroll women who are eligible to enroll under 
        such a State plan or such a State child health plan as a 
        parent.
            (4) If determined appropriate by the Commission, any 
        recommendations for the Department of Health and Human 
        Services, or such State plans and such State child health 
        plans, to ensure continuity of coverage under such a State plan 
        or such a State child health plan for pregnant and postpartum 
        women.
    (b) Postpartum Defined.--In this section, the term ``postpartum'' 
means the 1-year period beginning on the last day of a woman's 
pregnancy.
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