IMPACT to Save Moms Act

II 117TH CONGRESS 1ST SESSION S. 334 To establish an alternative payment model demonstration project for mater- nity 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘IMPACT to Save 4 Moms Act’’. 5 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 334 IS SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL 1 DEMONSTRATION PROJECT. 2 (a) IN GENERAL.—For the period of fiscal years 3 2022 through 2026, the Secretary of Health and Human 4 Services (referred to in this section as the ‘‘Secretary’’), 5 acting through the Administrator of the Centers for Medi- 6 care & Medicaid Services, shall establish and implement, 7 in accordance with the requirements of this section, a 8 demonstration project, to be known as the Perinatal Care 9 Alternative Payment Model Demonstration Project (re- 10 ferred to in this section as the ‘‘Demonstration Project’’), 11 for purposes of allowing States to test payment models 12 under their State plans under title XIX of the Social Secu- 13 rity Act (42 U.S.C. 1396 et seq.) and State child health 14 plans under title XXI of such Act (42 U.S.C. 1397aa et 15 seq.) with respect to maternity care provided to pregnant 16 and postpartum individuals enrolled in such State plans 17 and State child health plans. 18 (b) COORDINATION.—In establishing the Demonstra- 19 tion Project, the Secretary shall coordinate with stake- 20 holders such as— 21 (1) State Medicaid programs; 22 (2) maternity care providers and organizations 23 representing maternity care providers; 24 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 334 IS (3) relevant organizations representing patients, 1 with a particular focus on patients from racial and 2 ethnic minority groups; 3 (4) relevant community-based organizations, 4 particularly organizations that seek to improve ma- 5 ternal health outcomes for pregnant and postpartum 6 individuals from racial and ethnic minority groups; 7 (5) perinatal health workers; 8 (6) relevant health insurance issuers; 9 (7) hospitals, health systems, midwifery prac- 10 tices, freestanding birth centers (as such term is de- 11 fined in paragraph (3)(B) of section 1905(l) of the 12 Social Security Act (42 U.S.C. 1396d(l)), federally 13 qualified health centers (as such term is defined in 14 paragraph (2)(B) of such section), and rural health 15 clinics (as such term is defined in section 1861(aa) 16 of such Act (42 U.S.C. 1395x(aa))); 17 (8) researchers and policy experts in fields re- 18 lated to maternity care payment models; and 19 (9) any other stakeholders as the Secretary de- 20 termines appropriate, with a particular focus on 21 stakeholders from racial and ethnic minority groups. 22 (c) CONSIDERATIONS.—In establishing the Dem- 23 onstration Project, the Secretary shall consider any alter- 24 native payment model that— 25 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 334 IS (1) is designed to improve maternal health out- 1 comes for racial and ethnic groups with dispropor- 2 tionate rates of adverse maternal health outcomes; 3 (2) includes methods for stratifying patients by 4 pregnancy risk level and, as appropriate, adjusting 5 payments under such model to take into account 6 pregnancy risk level; 7 (3) establishes evidence-based quality metrics 8 for such payments; 9 (4) includes consideration of non-hospital birth 10 settings such as freestanding birth centers (as so de- 11 fined); 12 (5) includes consideration of social deter- 13 minants of maternal health; or 14 (6) includes diverse maternity care teams that 15 include— 16 (A) maternity care providers, mental and 17 behavioral health care providers acting in ac- 18 cordance with State law, registered dietitians or 19 nutrition professionals (as such term is defined 20 in section 1861(vv)(2) of the Social Security 21 Act (42 U.S.C. 1395x(vv)(2))), and Inter- 22 national Board Certified Lactation Consult- 23 ants— 24 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 334 IS (i) from racially, ethnically, and pro- 1 fessionally diverse backgrounds; 2 (ii) with experience practicing in ra- 3 cially and ethnically diverse communities; 4 or 5 (iii) who have undergone training on 6 implicit bias and racism; and 7 (B) perinatal health workers. 8 (d) ELIGIBILITY.—To be eligible to participate in the 9 Demonstration Project, a State shall submit an applica- 10 tion to the Secretary at such time, in such manner, and 11 containing such information as the Secretary may require. 12 (e) EVALUATION.—The Secretary shall conduct an 13 evaluation of the Demonstration Project to determine the 14 impact of the Demonstration Project on— 15 (1) maternal health outcomes, with data strati- 16 fied by race, ethnicity, socioeconomic indicators, and 17 any other factors as the Secretary determines appro- 18 priate; 19 (2) spending on maternity care by States par- 20 ticipating in the Demonstration Project; 21 (3) to the extent practicable, qualitative and 22 quantitative measures of patient experience; and 23 (4) any other areas of assessment that the Sec- 24 retary determines relevant. 25 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 334 IS (f) REPORT.—Not later than 1 year after the comple- 1 tion or termination date of the Demonstration Project, the 2 Secretary shall submit to the Congress, and make publicly 3 available, a report containing— 4 (1) the results of any evaluation conducted 5 under subsection (e); and 6 (2) a recommendation regarding whether the 7 Demonstration Project should be continued after fis- 8 cal year 2026 and expanded on a national basis. 9 (g) AUTHORIZATION OF APPROPRIATIONS.—There 10 are authorized to be appropriated such sums as are nec- 11 essary to carry out this section. 12 (h) DEFINITIONS.—In this section: 13 (1) ALTERNATIVE PAYMENT MODEL.—The 14 term ‘‘alternative payment model’’ has the meaning 15 given such term in section 1833(z)(3)(C) of the So- 16 cial Security Act (42 U.S.C. 1395l(z)(3)(C)). 17 (2) PERINATAL.—The term ‘‘perinatal’’ means 18 the period beginning on the day an individual be- 19 comes pregnant and ending on the last day of the 20 1-year period beginning on the last day of such indi- 21 vidual’s pregnancy. 22 (3) RACIAL AND ETHNIC MINORITY GROUP.— 23 The term ‘‘racial and ethnic minority group’’ has the 24 meaning given such term in section 1707(g)(1) of 25 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 334 IS the Public Health Service Act (42 U.S.C. 300u– 1 6(g)(1)). 2 SEC. 3. MACPAC REPORT. 3 Not later than 2 years after the date of the enact- 4 ment of this Act, the Medicaid and CHIP Payment and 5 Access Commission shall publish a report on issues relat- 6 ing to the continuity of coverage under State plans under 7 title XIX of the Social Security Act (42 U.S.C. 1396 et 8 seq.) and State child health plans under title XXI of such 9 Act (42 U.S.C. 1397aa et seq.) for pregnant and 10 postpartum individuals. Such report shall, at a minimum, 11 include the following: 12 (1) An assessment of any existing policies 13 under such State plans and such State child health 14 plans regarding presumptive eligibility for pregnant 15 individuals while their application for enrollment in 16 such a State plan or such a State child health plan 17 is being processed. 18 (2) An assessment of any existing policies 19 under such State plans and such State child health 20 plans regarding measures to ensure continuity of 21 coverage under such a State plan or such a State 22 child health plan for pregnant and postpartum indi- 23 viduals, including such individuals who need to 24 change their health insurance coverage during their 25 VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 334 IS pregnancy or the postpartum period following their 1 pregnancy. 2 (3) An assessment of any existing policies 3 under such State plans and such State child health 4 plans regarding measures to automatically reenroll 5 individuals who are eligible to enroll under such a 6 State plan or such a State child health plan as a 7 parent. 8 (4) If determined appropriate by the Commis- 9 sion, any recommendations for the Department of 10 Health and Human Services, or such State plans 11 and such State child health plans, to ensure con- 12 tinuity of coverage under such a State plan or such 13 a State child health plan for pregnant and 14 postpartum individuals. 15 Æ VerDate Sep 11 2014 04:40 Mar 02, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S334.IS S334 pbinns on DSKJLVW7X2PROD with BILLS