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