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<dc:title>117 S1333 IS: Modernizing Obstetric Medicine Standards Act of 2021</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-04-22</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 1333</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210422">April 22, 2021</action-date><action-desc><sponsor name-id="S331">Mrs. Gillibrand</sponsor> introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To address maternal mortality and morbidity.</official-title></form><legis-body display-enacting-clause="yes-display-enacting-clause"><section section-type="section-one" id="S1"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Modernizing Obstetric Medicine Standards Act of 2021</short-title></quote> or the <quote><short-title>MOMS Act</short-title></quote>.</text></section><section id="id80860913DD8F42ADA1DAFF4B06B2DDBC"><enum>2.</enum><header>Maternal mortality and morbidity prevention</header><text display-inline="no-display-inline">Section 317K of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12</external-xref>) is amended—</text><paragraph id="id2C516114D48C41D8A13919AEE85F7E49"><enum>(1)</enum><text>by redesignating subsections (e) and (f) as subsections (g) and (h), respectively; and</text></paragraph><paragraph id="idAECAB00B447640CA9E238306D1217F1D"><enum>(2)</enum><text display-inline="yes-display-inline">by inserting after subsection (d) the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idE60BFE5D76A3489BBF98879B497EEE52"><subsection id="id70624B7FD98048BC89619B16633BC232"><enum>(e)</enum><header>Pregnancy and postpartum safety and monitoring practices and maternal mortality and morbidity prevention</header><paragraph id="id3B1470A3AD444D3A9F57570464C86C24"><enum>(1)</enum><header>Alliance for Innovation on Maternal Health</header><text>The Secretary, acting through the Associate Administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, shall establish a program, known as the Alliance for Innovation on Maternal Health program, to—</text><subparagraph id="idD498BDA5766247EABDD0C3DB08D6F056"><enum>(A)</enum><text>enter into a contract with an interdisciplinary, multi-stakeholder, national organization promulgating a national data-driven maternal safety and quality improvement initiative based on evidence-based best practices to improve maternal safety and outcomes;</text></subparagraph><subparagraph id="idB16B3DEB9E104137A113566E80DD063B"><enum>(B)</enum><text>assist States with the development and implementation of postpartum safety and monitoring practices and maternal mortality and morbidity prevention, based on the best practices developed under paragraph (2); and</text></subparagraph><subparagraph id="id17F418706E55433690281738D6716619"><enum>(C)</enum><text>improve State-specific maternal health outcomes and reduce variation in response to maternity and postpartum care, in order to eliminate preventable maternal mortality and severe maternal morbidity.</text></subparagraph></paragraph><paragraph id="ide7dab46e80ab43deb186bef9fa8dbd28"><enum>(2)</enum><header>Best practices</header><subparagraph id="id63E277BBFE034A35B0211B2A41A6A058"><enum>(A)</enum><header>In general</header><text>Not later than 1 year after the date of enactment of the <short-title>Modernizing Obstetric Medicine Standards Act of 2021</short-title>, the Secretary, acting through the Administrator of the Health Resources and Services Administration, shall work with the contracting entity under paragraph (1)(A) to—</text><clause id="id683D41E2439B4483B1772960D3931BCA"><enum>(i)</enum><text>create and assist State-based collaborative teams in the implementation of standardized best practices, to be known as <quote>maternal safety bundles</quote>, for the purpose of maternal mortality and morbidity prevention; and</text></clause><clause id="id54945DADA92B433DB7920DB6DE0BE4D6"><enum>(ii)</enum><text>collect and analyze data related to process structure and patient outcomes to drive continuous quality improvement in the implementation of the maternal safety bundles by such State-based teams.</text></clause></subparagraph><subparagraph id="idD36CC25E59DF4B1BA6D359797BF27F82"><enum>(B)</enum><header>Maternal safety bundles</header><text>The best practices issued under subparagraph (A) may address the following topics:</text><clause id="id9EC45321495C4792BCC5E314C7B42C69"><enum>(i)</enum><text>Obstetric hemorrhage.</text></clause><clause id="id05FE9128747046768C73C22133AC71BB"><enum>(ii)</enum><text>Maternal mental, behavioral, and emotional health.</text></clause><clause id="idE4F30FCE3181433E8A5FE85A877CB77F"><enum>(iii)</enum><text>Maternal venous and thromboembolism.</text></clause><clause id="id3FDC873567474A74BE0E0CCD80696ED3"><enum>(iv)</enum><text>Severe hypertension in pregnancy, including preeclampsia.</text></clause><clause id="idC84ABEAD5BBB4F2A8ECAA40C571FA7AD"><enum>(v)</enum><text>Obstetric care for women with substance abuse disorder.</text></clause><clause id="idB9B0F53EE4764866A332651F0D1A8E8F"><enum>(vi)</enum><text>Postpartum care basics for maternal safety.</text></clause><clause id="id78FC25B43ABD4F9083BA61A6385E055D"><enum>(vii)</enum><text>Reduction of racial and ethnic disparities in maternity care.</text></clause><clause id="id88BE5EA02DC7491986FC13DDD39B4513"><enum>(viii)</enum><text>Safe reduction of primary cesarean birth.</text></clause><clause id="id19AB169A472A47F58A37072A9C597872"><enum>(ix)</enum><text>Severe maternal morbidity review.</text></clause><clause id="id2D329F511BA94937A50FEC04AA7A223E"><enum>(x)</enum><text>Support after a severe maternal morbidity event.</text></clause><clause id="id56555C0CB18C472896B9CDE387C0FCCB"><enum>(xi)</enum><text>Ways to empower and listen to women before, during, and after childbirth to ensure better communication between patients and health care providers.</text></clause><clause id="id6FAA4D4156474BBD89D1D489246F82E9"><enum>(xii)</enum><text>Other leading causes of maternal mortality and morbidity, including infection or sepsis and cardiomyopathy.</text></clause></subparagraph></paragraph><paragraph commented="no" id="id7D06049071F245F382485BB04E1B437F"><enum>(3)</enum><header>Authorization of appropriations</header><text>To carry out this subsection, in addition to amounts appropriated under subsection (h), there are authorized to be appropriated $5,000,000 for each of fiscal years 2022 through 2026.</text></paragraph></subsection><after-quoted-block>. </after-quoted-block></quoted-block></paragraph></section><section id="id9A50857F0105494D89A69B8D2AF97BF2"><enum>3.</enum><header>Maternal mortality and morbidity prevention grants</header><text display-inline="no-display-inline">Section 317K of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-12">42 U.S.C. 247b–12</external-xref>), as amended by section 2, is further amended—</text><paragraph id="id48C34CD5A17943CA9B9E70CDA29ED1E5"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting after subsection (e) the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id97B19CD3EF5D4767A8069B0259162176"><subsection id="id246C19D03587419EAF4DC706773D7C9A"><enum>(f)</enum><header>Maternal mortality and morbidity prevention grant program</header><paragraph id="idCD720D8B10164649B8D3043BACDB0E69"><enum>(1)</enum><header>In general</header><text>The Secretary, acting through the Associate Administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, shall award grants to States or hospitals to assist in the development and implementation of the maternal safety bundles described in subsection (e)(2).</text></paragraph><paragraph id="idCFCEC9FC011A4158BAFFF771E3492B55"><enum>(2)</enum><header>Use of funds</header><subparagraph id="id423DD0CA939A4C5ABA1544AB8B175BED"><enum>(A)</enum><header>In general</header><text>A State or hospital receiving a grant under this subsection may use such funds—</text><clause id="idD3DC9F9B2CE94DCDBB1B213B0E86B03B"><enum>(i)</enum><text>to purchase equipment and supplies to effectively implement and execute the maternal safety bundles described in subsection (e)(2); and</text></clause><clause id="id87E425036E15422B8DC4CA9F61F3601D"><enum>(ii)</enum><text>to develop training on, and evaluation of the effectiveness of, such maternal safety bundles.</text></clause></subparagraph><subparagraph id="id980D1B3000804DB5AFA7672D257C966A"><enum>(B)</enum><header>Priority use of funds for State grantees</header><text>A State receiving a grant under this subsection shall allocate such funds giving priority to the hospitals in such State that serve high volumes of low-income, at-risk, or rural populations.</text></subparagraph></paragraph><paragraph id="id0E976D7033AA42D496143E327E0819DC"><enum>(3)</enum><header>Prioritization of Grant applications</header><text>In awarding grants under this subsection, the Secretary shall prioritize applications from States, or hospitals within States, that—</text><subparagraph id="id44D00014784743588B6B55BFB67558A4"><enum>(A)</enum><text>have a functioning maternal mortality review committee in accordance with best practices promulgated by the Building U.S. Capacity to Review and Prevent Maternal Deaths Initiative of the Centers for Disease Control and Prevention, the CDC Foundation, and the Association of Maternal and Child Health Programs, or as described in subsection (d)(1); or</text></subparagraph><subparagraph id="id402306B2C46E4AAAAC17E2EFA62F6588"><enum>(B)</enum><text>serve high volumes of low-income, at-risk, or rural populations.</text></subparagraph></paragraph><paragraph id="id451FF20B44A74A8CA8335A962D603E17"><enum>(4)</enum><header>Reporting Requirements</header><subparagraph id="idDA4C95C1BA6D461880DF351636F08C04"><enum>(A)</enum><header>In general</header><text>Not later than 2 years after receipt of a grant under this subsection, each recipient of such a grant shall submit a report to the Secretary describing—</text><clause id="id70F1032AD21240A998428D9A70C2DD02"><enum>(i)</enum><text>implementation of the maternal safety bundles with use of the grant funds;</text></clause><clause id="id68702565CA9B4FF3B725A58B32BB2247"><enum>(ii)</enum><text>any incidents of pregnancy-related deaths or pregnancy-associated deaths, and any pregnancy-related complications or pregnancy-associated complications occurring in the 1-year period prior to implementation of such procedures; and</text></clause><clause id="id07C073B9800B415686B47011C1EE3838"><enum>(iii)</enum><text>any incidents of pregnancy-related deaths or pregnancy-associated deaths, and any pregnancy-related complications or pregnancy-associated complications occurring after implementation of such procedures.</text></clause></subparagraph><subparagraph id="idCB2A4F306ED5483C99CD917A45087584"><enum>(B)</enum><header>Public availability; report to Congress</header><text>Within 1 year of receiving the reports under subparagraph (A), the Secretary shall—</text><clause id="idC6A96FB59CB241FE9B3EE1235C248206"><enum>(i)</enum><text>make the reports submitted under subparagraph (A) publicly available; and</text></clause><clause id="idf9d6ef842cf64796abf7ddaa7ae16c76"><enum>(ii)</enum><text>submit a report to Congress that describes the grants awarded under this subsection, the effectiveness of the grant program under this subsection, the activities for which grant funds were used, and any recommendations to further prevent maternal mortality and morbidity.</text></clause></subparagraph><subparagraph id="idDB2AC5173E084EA2A1A8A8193C0CC474"><enum>(C)</enum><header>Authorization of appropriations</header><text>To carry out this subsection, in addition to amounts appropriated under subsection (h), there are authorized to be appropriated $40,000,000 for each of fiscal years 2022 through 2026.</text></subparagraph></paragraph></subsection><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph id="id2BCDE0547DA44AE3B027B340CFD436DF"><enum>(2)</enum><text>in subsection (g), as so redesignated by section 2(1), by striking paragraphs (2) and (3) and inserting the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idED4D8D58334D46C7B097DBB228E50AA2"><paragraph id="idFFD3C16E8F6E4703B2F2FFC433FC98AB"><enum>(2)</enum><text>the terms <term>pregnancy-associated death</term> and <term>pregnancy-associated complication</term> mean the death or medical complication, respectively, of a woman that occurs during, or within 1 year following, her pregnancy, regardless of the outcome, duration, or site of the pregnancy;</text></paragraph><paragraph id="id64A961A8FCE6400B82C5792E6C36DE6C"><enum>(3)</enum><text>the terms <term>pregnancy-related death</term> and <term>pregnancy-related complication</term> mean the death or medical complication, respectively, of a woman that—</text><subparagraph id="id37CD0A5FD6EB4E128B05B43F71313269"><enum>(A)</enum><text>occurs during, or within 1 year following, her pregnancy, regardless of the outcome, duration, or site of the pregnancy;</text></subparagraph><subparagraph id="id67c2f1dfe83149e299e38daf09b94397"><enum>(B)</enum><text>is from any cause related to, or aggravated by, the pregnancy or its management; and</text></subparagraph><subparagraph id="idb912fd266a554bddadc012e2798fb523"><enum>(C)</enum><text>is not from an accidental or incidental cause; and</text></subparagraph></paragraph><paragraph id="idc6174dad416c47b78eebd0d4ed99e339"><enum>(4)</enum><text>the term <term>severe maternal morbidity</term> means the unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="id587057A9A7B242BEBFAB850AE0F04210"><enum>4.</enum><header>Reporting on pregnancy-related and pregnancy-associated deaths and complications</header><subsection id="idD00ED002DE0C4525B9065752270A60D2"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services shall encourage each State to voluntarily submit to the Secretary each year a report containing the findings of a State maternal mortality review committee with respect to each maternal death in the State that the committee reviewed during the year. </text></subsection><subsection id="id9a678ca1fae4453bb37bc7dbde232213"><enum>(b)</enum><header>Maternal and infant health</header><text>The Director of the Centers for Disease Control and Prevention shall—</text><paragraph id="id1B5AEF40AAF04655A44983A758EDF6CC"><enum>(1)</enum><text>update the Pregnancy Mortality Surveillance System or develop a separate system so that such system is capable of including data obtained from State maternal mortality review committees; and</text></paragraph><paragraph id="id8EA6B6BB1D9848A5AD6837DB1B5E0BB7"><enum>(2)</enum><text>provide technical assistance to States in reviewing cases of pregnancy-related complications and pregnancy-associated complications.</text></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idFD4F54CC487E49F5A53F68422ADA6FD6"><enum>(c)</enum><header>Definitions</header><text>In this section, the terms <term>pregnancy-associated complication</term> and <term>pregnancy-related complication</term> have the meanings given such terms in section 317K of the Public Health Service Act, as amended by section 3.</text></subsection></section></legis-body></bill>


