[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3346 Introduced in House (IH)]

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118th CONGRESS
  1st Session
                                H. R. 3346

  To direct the Administrator of the Centers for Medicare & Medicaid 
  Services to implement the Perinatal Care Alternative Payment Model 
 Demonstration Project to test various payment models with respect to 
maternity care provided to pregnant and postpartum individuals, and for 
                            other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 15, 2023

  Ms. Schakowsky (for herself, Mr. Aguilar, Mr. Allred, Ms. Barragan, 
  Mrs. Beatty, Mr. Blumenauer, Ms. Blunt Rochester, Ms. Brownley, Ms. 
Budzinski, Ms. Bush, Ms. Caraveo, Mr. Carbajal, Mr. Carson, Mr. Carter 
  of Louisiana, Mrs. Cherfilus-McCormick, Ms. Clarke of New York, Mr. 
Cleaver, Mr. Cohen, Ms. Craig, Ms. Crockett, Mr. Davis of Illinois, Ms. 
   Dean of Pennsylvania, Ms. Escobar, Mr. Espaillat, Mr. Evans, Mrs. 
 Foushee, Mr. Garamendi, Ms. Garcia of Texas, Mr. Garcia of Illinois, 
 Mr. Green of Texas, Mrs. Hayes, Mr. Horsford, Mr. Huffman, Mr. Ivey, 
   Mr. Jackson of Illinois, Ms. Jacobs, Ms. Jayapal, Mr. Johnson of 
Georgia, Ms. Kamlager-Dove, Mr. Krishnamoorthi, Ms. Kuster, Ms. Lee of 
  California, Mr. Lieu, Ms. Lofgren, Mrs. McBath, Mrs. McClellan, Ms. 
 McCollum, Mr. McGovern, Mr. Meeks, Ms. Meng, Mr. Mfume, Mr. Morelle, 
   Mr. Moulton, Ms. Moore of Wisconsin, Mr. Mrvan, Mr. Mullin, Mrs. 
 Napolitano, Mr. Neguse, Ms. Ocasio-Cortez, Mr. Pappas, Mr. Payne, Mr. 
Phillips, Ms. Porter, Ms. Pressley, Mr. Ruppersberger, Ms. Salinas, Ms. 
 Scanlon, Mr. Schiff, Mr. Schneider, Ms. Scholten, Mr. David Scott of 
Georgia, Ms. Sewell, Mr. Smith of Washington, Mr. Soto, Ms. Spanberger, 
 Ms. Stansbury, Ms. Strickland, Mrs. Sykes, Mr. Takano, Ms. Tlaib, Ms. 
 Tokuda, Mr. Tonko, Mrs. Torres of California, Mrs. Trahan, Mr. Trone, 
  Mr. Vargas, Mr. Veasey, Ms. Velazquez, Ms. Wasserman Schultz, Mrs. 
Watson Coleman, Ms. Wexton, Ms. Williams of Georgia, Mr. Pascrell, Ms. 
   DelBene, and Mr. Lynch) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To direct the Administrator of the Centers for Medicare & Medicaid 
  Services to implement the Perinatal Care Alternative Payment Model 
 Demonstration Project to test various payment models with respect to 
maternity care provided to pregnant and postpartum individuals, 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''.

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

    (a) In General.--For the period of fiscal years 2024 through 2028, 
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 demographic groups with 
        elevated rates of maternal mortality, severe maternal 
        morbidity, maternal health disparities, or other adverse 
        perinatal or childbirth outcomes;
            (4) relevant community-based organizations, particularly 
        organizations that seek to improve maternal health outcomes for 
        individuals from demographic groups with elevated rates of 
        maternal mortality, severe maternal morbidity, maternal health 
        disparities, or other adverse perinatal or childbirth outcomes;
            (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 
        demographic groups with elevated rates of maternal mortality, 
        severe maternal morbidity, maternal health disparities, or 
        other adverse perinatal or childbirth outcomes.
    (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 
        individuals from demographic groups with elevated rates of 
        maternal mortality, severe maternal morbidity, maternal health 
        disparities, or other adverse perinatal or childbirth 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, including 
        consideration of the appropriate transfer of patients by 
        pregnancy risk level;
            (3) establishes evidence-based quality metrics for such 
        payments;
            (4) includes consideration of nonhospital birth settings 
        such as freestanding birth centers (as so defined);
            (5) includes consideration of social determinants of 
        maternal health;
            (6) includes diverse maternity care teams that include--
                    (A) maternity care providers, mental and behavioral 
                health care providers acting in accordance with State 
                law, and registered dietitians or nutrition 
                professionals (as such term is defined in section 
                1395x(vv)(2) of title 42, United States Code)--
                            (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; or
            (7) includes consideration of maternal mental health 
        conditions and substance use disorders.
    (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, primary language, socioeconomic status, geography, 
        insurance type, and 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 one 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 2028 and expanded 
        on a national basis.
    (g) 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) Maternal mortality.--The term ``maternal mortality'' 
        means a death occurring during or within a 1-year period after 
        pregnancy, caused by pregnancy-related or childbirth 
        complications, including a suicide, overdose, or other death 
        resulting from a mental health or substance use disorder 
        attributed to or aggravated by pregnancy-related or childbirth 
        complications.
            (2) Maternity care provider.--The term ``maternity care 
        provider'' means a health care provider who--
                    (A) is a physician, a physician assistant, a 
                midwife who meets, at a minimum, the international 
                definition of a midwife and global standards for 
                midwifery education as established by the International 
                Confederation of Midwives, an advanced practice 
                registered nurse, or a lactation consultant certified 
                by the International Board of Lactation Consultant 
                Examiners; and
                    (B) has a focus on maternal or perinatal health.
            (3) 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.
            (4) Perinatal health worker.--The term ``perinatal health 
        worker'' means a nonclinical health worker focused on maternal 
        or perinatal health, such as a doula, community health worker, 
        peer supporter, lactation educator or counselor, nutritionist 
        or dietitian, childbirth educator, social worker, home visitor, 
        patient navigator or coordinator, or language interpreter.
            (5) Postpartum and postpartum period.--The terms 
        ``postpartum'' and ``postpartum period'' refer to the 1-year 
        period beginning on the last day of the pregnancy of an 
        individual.
            (9) Severe maternal morbidity.--The term ``severe maternal 
        morbidity'' means a health condition, including mental health 
        conditions and substance use disorders, attributed to or 
        aggravated by pregnancy or childbirth that results in 
        significant short-term or long-term consequences to the health 
        of the individual who was pregnant.
            (10) Social determinants of maternal health.--The term 
        ``social determinants of maternal health'' means nonclinical 
        factors that impact maternal health outcomes.
    (h) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
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