Maternal Immunization Enhancement Act

II 117TH CONGRESS 1ST SESSION S. 1114 To increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, and for other purposes. IN THE SENATE OF THE UNITED STATES APRIL 14, 2021 Ms. HASSAN (for herself and Mr. CASSIDY) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To increase vaccination rates among pregnant women enrolled in Medicaid or CHIP, 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 ‘‘Maternal Immuniza- 4 tion Enhancement Act’’. 5 SEC. 2. DEFINITIONS. 6 In this Act: 7 (1) ADULT HEALTH QUALITY MEASURES.—The 8 term ‘‘Adult Health Quality Measures’’ means the 9 core set of adult health quality measures developed 10 VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1114 IS and published under section 1139B of the Social Se- 1 curity Act (42 U.S.C. 1320b–9b). 2 (2) CHILD HEALTH QUALITY MEASURES.—The 3 term ‘‘Child Health Quality Measures’’ means the 4 core set of child health quality measures developed 5 and published under section 1139A of the Social Se- 6 curity Act (42 U.S.C. 1320b–9a). 7 (3) CHIP.—The term ‘‘CHIP’’ means the Chil- 8 dren’s Health Insurance Program established under 9 title XXI of the Social Security Act (42 U.S.C. 10 1397aa et seq.) and includes any waivers of such 11 program. 12 (4) MEDICAID.—The term ‘‘Medicaid’’ means 13 the medical assistance program established under 14 title XIX of the Social Security Act (42 U.S.C. 1396 15 et seq.) and includes any waivers of such program. 16 (5) SECRETARY.—The term ‘‘Secretary’’ means 17 the Secretary of Health and Human Services. 18 (6) STATE.—The term ‘‘State’’ has the mean- 19 ing given that term for purposes of title XIX of the 20 Social Security Act (42 U.S.C. 1396 et seq.). 21 VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1114 IS SEC. 3. CMS GUIDANCE ON INCREASING VACCINATION 1 RATES AMONG PREGNANT WOMEN EN- 2 ROLLED IN MEDICAID OR CHIP. 3 (a) IN GENERAL.—Not later than 1 year after the 4 date of enactment of this Act, the Administrator of the 5 Centers for Medicare & Medicaid Services, in consultation 6 with the Director of the Centers for Disease Control and 7 Prevention, shall issue guidance to States on increasing 8 the vaccination rates for Advisory Committee on Immuni- 9 zation Practices recommended vaccines among pregnant 10 and postpartum women enrolled in Medicaid or CHIP. 11 The guidance issued under this subsection shall be up- 12 dated as necessary not later than 5 years after the date 13 of enactment of this Act in consultation with the Director 14 of the Centers for Disease Control and Prevention and the 15 results of the report to Congress required under section 16 5 by the Comptroller General of the United States. 17 (b) REQUIREMENTS.—The guidance issued under 18 subsection (a) (and any update of such guidance) shall at 19 a minimum include options and best practices for— 20 (1) increasing the vaccination rates for Advi- 21 sory Committee on Immunization Practices rec- 22 ommended vaccines among pregnant women, par- 23 ticularly with respect to the influenza, diphtheria, 24 tetanus, and whooping cough (pertussis) vaccines; 25 VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1114 IS (2) ways in which States may obtain Federal 1 matching payments under Medicaid and CHIP for 2 obtaining and administering such recommended vac- 3 cines to pregnant and postpartum women, and rec- 4 ommendations for improving provider participation 5 under Medicaid and CHIP with respect to obtaining 6 and administering such recommended vaccines to 7 pregnant and postpartum women; and 8 (3) ways in which State Medicaid programs 9 may amplify Federal, State, and local health depart- 10 ment recommendations on providing counseling and 11 patient outreach and education regarding such vac- 12 cines. 13 SEC. 4. INCLUSION OF PRENATAL IMMUNIZATION STATUS 14 FOR PREGNANT WOMEN QUALITY MEASURE 15 IN THE CORE SETS OF HEALTH CARE QUAL- 16 ITY MEASURES FOR CHILDREN ENROLLED IN 17 MEDICAID OR CHIP AND ADULTS ENROLLED 18 IN MEDICAID. 19 (a) IN GENERAL.—Not later than 2 years after the 20 date of enactment of this Act, and after consulting with 21 the stakeholders described in section 1139A(b)(3) of the 22 Social Security Act (42 U.S.C. 1320b–9a(b)(3)), the Sec- 23 retary shall consider adding a prenatal immunization sta- 24 tus for pregnant women quality measure in either the— 25 VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1114 IS (1) Child’s Health Quality Measures; or 1 (2) Adult Health Quality Measures. 2 (b) REQUIREMENT.—If the Secretary includes a pre- 3 natal immunization status for pregnant women quality 4 measure in either such core set of health quality measures, 5 the quality measure shall measure the percentage of deliv- 6 eries in which pregnant women received vaccines rec- 7 ommended by the Advisory Committee on Immunization 8 Practices of the Centers for Disease Control and Preven- 9 tion during pregnancy. 10 SEC. 5. GAO REPORT. 11 Not later than 2 years after the date of enactment 12 of this Act, the Comptroller General of the United States 13 shall submit a report to Congress on the vaccination rates 14 among pregnant women enrolled in Medicaid or CHIP 15 with respect to the Advisory Committee on Immunization 16 Practices vaccines recommended for pregnant women. To 17 the extent data are available, the report shall include the 18 following: 19 (1) The percentage of pregnant women enrolled 20 in Medicaid or CHIP who did not receive vaccines 21 paid for by Medicaid or CHIP as recommended by 22 the Advisory Committee on Immunization Practices 23 while pregnant. 24 VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1114 IS (2) To the extent practicable, an analysis of 1 whether structural barriers, such as cost sharing or 2 other specific requirements, are imposed under Med- 3 icaid or CHIP which impact the vaccination rates 4 among pregnant women enrolled in Medicaid or 5 CHIP with respect to the Advisory Committee on 6 Immunization Practices vaccines recommended for 7 pregnant women. 8 (3) To the extent practicable, an analysis of the 9 reasons why women enrolled in Medicaid or CHIP 10 do not receive such recommended vaccines rec- 11 ommended while pregnant. 12 (4) To the extent practicable, demographic de- 13 tails regarding the population of pregnant women 14 enrolled in Medicaid or CHIP, including race, eth- 15 nicity, and rural or urban geographic location. 16 (5) As the Comptroller General deems appro- 17 priate, recommendations for legislative or adminis- 18 trative actions relating to increasing the vaccination 19 rates among pregnant women enrolled in Medicaid 20 or CHIP with respect to the Advisory Committee on 21 Immunization Practices vaccines recommended for 22 pregnant women. 23 Æ VerDate Sep 11 2014 01:53 Apr 27, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6301 E:\BILLS\S1114.IS S1114 kjohnson on DSK79L0C42PROD with BILLS