[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4482 Introduced in Senate (IS)]

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119th CONGRESS
  2d Session
                                S. 4482

To amend title XVIII of the Social Security Act to require hospitals to 
  develop discharge plans for pregnant individuals as a condition of 
         participation under Medicare, 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 amend title XVIII of the Social Security Act to require hospitals to 
  develop discharge plans for pregnant individuals as a condition of 
         participation under Medicare, 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 ``Women Expansion of Learning and 
Labor Safety Act'' or the ``WELLS Act''.

SEC. 2. REQUIRING HOSPITALS PARTICIPATING IN MEDICARE TO DEVELOP 
              DISCHARGE PLANS FOR PREGNANT INDIVIDUALS.

    Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is 
amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (X), by striking ``and'' at the 
                end;
                    (B) in subparagraph (Y), by striking the period at 
                the end and inserting ``, and''; and
                    (C) by adding at the end the following new 
                subparagraph:
            ``(Z) beginning January 1, 2027, in the case of a hospital, 
        critical access hospital, or rural emergency hospital, to 
        comply with the requirements described in subsection (l)(1).''; 
        and
            (2) by adding at the end the following new subsection:
    ``(l) Discharge Plan Requirements for Pregnant Individuals.--
            ``(1) In general.--For purposes of subsection (a)(1)(Z), 
        the requirements described in this paragraph are, with respect 
        to a hospital, critical access hospital, or rural emergency 
        hospital, that the hospital--
                    ``(A) provides for the development and 
                implementation of a discharge plan meeting the 
                standards under paragraph (2) with respect to any 
                individual (whether or not eligible for benefits under 
                this title) admitted to the hospital who--
                            ``(i) is pregnant;
                            ``(ii) is experiencing signs or symptoms 
                        consistent with labor, which may include 
                        contractions; and
                            ``(iii) is expected to be discharged from 
                        the hospital, critical access hospital, or 
                        rural emergency hospital prior to delivery, as 
                        determined based on the documented clinical 
                        judgment of the treating physician or 
                        practitioner at the time that such discharge is 
                        contemplated;
                    ``(B) includes such discharge plan in the 
                individual's medical record; and
                    ``(C) provides for such discharge plan to be 
                discussed with the individual (or the individual's 
                representative) prior to discharge.
            ``(2) Discharge plan standards.--A discharge plan for an 
        individual described in paragraph (1)(A) meets the standards 
        under this paragraph if such plan includes at least the 
        following information:
                    ``(A) A clinical justification for the discharge.
                    ``(B) An assessment of travel distance and time 
                between the primary residence of the individual and the 
                hospital, critical access hospital, or rural emergency 
                hospital.
                    ``(C) Verification of reliable transportation 
                between the primary residence of the individual and the 
                hospital, critical access hospital, or rural emergency 
                hospital.
                    ``(D) Identification of a secondary hospital or 
                facility at which such individual may obtain labor and 
                delivery services.
                    ``(E) Confirmation that the plan was reviewed and 
                approved by a registered professional nurse, social 
                worker, or other appropriately qualified personnel.
                    ``(F) Confirmation that the individual (or the 
                individual's representative) has received the 
                information described in subparagraphs (A) through (D), 
                that such information was provided in the primary 
                language of such individual (or representative), and 
                that such individual (or representative) confirmed 
                their understanding of such information.
            ``(3) Rule of construction.--Nothing in this subsection 
        shall be construed as limiting or otherwise affecting the 
        discharge planning requirements otherwise applicable to a 
        hospital, critical access hospital, or rural emergency hospital 
        under this title, or any obligation of a health care provider 
        to furnish emergency services as required under State or 
        Federal law, including section 1867 of this title (commonly 
        known as the `Emergency Medical Treatment and Labor Act').''.

SEC. 3. RURAL MATERNAL AND OBSTETRIC CARE TRAINING DEMONSTRATION 
              GRANTS.

    Section 764 of the Public Health Service Act (42 U.S.C. 294s) is 
amended--
            (1) by redesignating subsections (d) and (e) as subsections 
        (e) and (f), respectively;
            (2) by inserting after subsection (c) the following:
    ``(d) Minimum Performance Milestones.--
            ``(1) Establishment.--Beginning with the grants awarded 
        under this section for fiscal year 2027, the Secretary shall 
        establish minimum performance milestones that grant recipients 
        must meet during a fiscal year as a condition of remaining 
        eligible for funding through such a grant for any subsequent 
        fiscal year.
            ``(2) Milestones related to percent of staff trained.--The 
        minimum performance milestones referred to in paragraph (1) 
        shall include milestones related to the percent of all staff of 
        the grant recipient that are trained, or that receive refresher 
        training, with support from a grant under this section.''; and
            (3) in subsection (e), as so redesignated--
                    (A) in the subsection heading, by striking 
                ``Report'' and inserting ``Reports'';
                    (B) in paragraph (1)(B), by striking ``the report 
                described in paragraph (2)'' and inserting ``the 
                reports described in paragraphs (2) and (3)''; and
                    (C) by adding at the end the following:
            ``(3) Subsequent reports.--Not later than January 1, 2027, 
        and annually thereafter, the Secretary shall submit to 
        Congress, and make publicly available, a report that includes--
                    ``(A) updates to the information described in 
                subparagraphs (A) through (C) of paragraph (2); and
                    ``(B) additional information regarding the grants 
                under this section, including--
                            ``(i) a list of the entities receiving such 
                        grants;
                            ``(ii) the number and amount of such 
                        grants;
                            ``(iii) whether training supported by such 
                        grants was delivered in-person, virtually, 
                        asynchronously, or through some other format; 
                        and
                            ``(iv) descriptions of the geographical 
                        coverage of such grants, the number of 
                        providers trained under such grants, and 
                        patient-level metrics linked to such training 
                        (such as changes in clinical outcomes, patient 
                        experience, and racial disparities).''.

SEC. 4. MULTI-CENTER IMPLEMENTATION SCIENCE INITIATIVE FOR MATERNAL 
              HEALTH.

    (a) Establishment.--The Secretary of Health and Human Services, in 
consultation with the Director of the Agency for Healthcare Research 
and Quality and the Director of the National Institutes of Health (in 
this section referred to as the ``Secretary'') shall establish a multi-
center implementation science initiative for maternal health to 
rigorously evaluate different training models for health care 
professionals (including in-person, virtual, simulation, and cohort-
based) and the impact of such models on provider behavior, patient 
outcomes, and maternal health disparities.
    (b) Interagency Maternal Health Dashboard.--As part of the 
initiative described in subsection (a), the Secretary shall develop, 
maintain, and make publicly available on the website of the Department 
of Health and Human Services an interagency maternal health dashboard, 
which shall include maternal health outcome metrics from agencies 
within the Department of Health and Human Services.
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