[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4481 Introduced in Senate (IS)]
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119th CONGRESS
2d Session
S. 4481
To require the Secretary of Health and Human Services to establish a
demonstration project to allow States to test payment models for
maternity care provided to pregnant and postpartum individuals under
the Medicaid and CHIP programs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 11, 2026
Ms. Blunt Rochester introduced the following bill; which was read twice
and referred to the Committee on Finance
_______________________________________________________________________
A BILL
To require the Secretary of Health and Human Services to establish a
demonstration project to allow States to test payment models for
maternity care provided to pregnant and postpartum individuals under
the 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 ``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 2027 through 2031,
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 non-hospital 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 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 2031 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.
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