[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 334 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  1st Session
                                 S. 334

  To establish an alternative payment model demonstration project for 
 maternity care provided to pregnant and postpartum individuals under 
       State Medicaid and CHIP programs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           February 22, 2021

 Mr. Casey (for himself, Mr. Menendez, and Mr. Booker) introduced the 
 following bill; which was read twice and referred to the Committee on 
                                Finance

_______________________________________________________________________

                                 A BILL


 
  To establish an alternative payment model demonstration project for 
 maternity care provided to pregnant and postpartum individuals under 
       State Medicaid and CHIP programs, 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 ``IMPACT to Save Moms Act''.

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 individuals 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) maternity care providers and organizations representing 
        maternity care providers;
            (3) relevant organizations representing patients, with a 
        particular focus on patients from racial and ethnic minority 
        groups;
            (4) relevant community-based organizations, particularly 
        organizations that seek to improve maternal health outcomes for 
        pregnant and postpartum individuals from racial and ethnic 
        minority groups;
            (5) perinatal health workers;
            (6) relevant health insurance issuers;
            (7) hospitals, health systems, midwifery practices, 
        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 
        racial and ethnic minority groups.
    (c) Considerations.--In establishing the Demonstration Project, the 
Secretary shall consider any alternative payment model that--
            (1) is designed to improve maternal health outcomes for 
        racial and ethnic groups with disproportionate rates of adverse 
        maternal health outcomes;
            (2) includes methods for stratifying patients by pregnancy 
        risk level and, as appropriate, adjusting payments under such 
        model to take into account pregnancy risk level;
            (3) establishes evidence-based quality metrics for such 
        payments;
            (4) includes consideration of non-hospital birth settings 
        such as freestanding birth centers (as so defined);
            (5) includes consideration of social determinants of 
        maternal health; or
            (6) includes diverse maternity care teams that include--
                    (A) maternity care providers, mental and behavioral 
                health care providers acting in accordance with State 
                law, registered dietitians or nutrition professionals 
                (as such term is defined in section 1861(vv)(2) of the 
                Social Security Act (42 U.S.C. 1395x(vv)(2))), and 
                International Board Certified Lactation Consultants--
                            (i) from racially, ethnically, and 
                        professionally diverse backgrounds;
                            (ii) with experience practicing in racially 
                        and ethnically diverse communities; or
                            (iii) who have undergone training on 
                        implicit bias and racism; and
                    (B) perinatal health workers.
    (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, qualitative and quantitative 
        measures of patient experience; and
            (4) any other areas of assessment that the Secretary 
        determines relevant.
    (f) Report.--Not later than 1 year after the completion or 
termination date of the Demonstration Project, the Secretary shall 
submit to the Congress, 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 an individual becomes pregnant and ending 
        on the last day of the 1-year period beginning on the last day 
        of such individual's pregnancy.
            (3) Racial and ethnic minority group.--The term ``racial 
        and ethnic minority group'' has the meaning given such term in 
        section 1707(g)(1) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)(1)).

SEC. 3. MACPAC REPORT.

    Not later than 2 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 individuals. 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 individuals 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 
        individuals, including such individuals 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 individuals 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 
        individuals.
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