COVID–19 Safe Birthing Act

I 117TH CONGRESS 1ST SESSION H. R. 2598 To amend title XVIII, XIX, and XXI of the Social Security Act and title XXVII of the Public Health Service Act to expand access to maternal health care, and for other purposes. IN THE HOUSE OF REPRESENTATIVES APRIL 15, 2021 Ms. PRESSLEY introduced the following bill; which was referred to the Com- mittee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, for a period to be subse- quently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend title XVIII, XIX, and XXI of the Social Security Act and title XXVII of the Public Health Service Act to expand access to maternal health care, 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 ‘‘COVID–19 Safe Birth- 4 ing Act’’. 5 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 2598 IH SEC. 2. EXPANDING ACCESS TO MATERNAL CARE IN HOS- 1 PITALS. 2 Section 1866(a)(1) of the Social Security Act (42 3 U.S.C. 1395cc(a)(1)) is amended— 4 (1) in subparagraph (X), by striking at the end 5 ‘‘and’’; 6 (2) in subparagraph (Y)(ii)(V), by striking the 7 period at the end and inserting ‘‘; and’’; and 8 (3) by inserting after subparagraph (Y)(ii)(V), 9 the following new subparagraph: 10 ‘‘(Z) beginning 30 days after the date of 11 enactment of this subparagraph, in the case of 12 a hospital— 13 ‘‘(i) to require that such hospital per- 14 mits a pregnant or birthing person to be 15 accompanied by an individual of the preg- 16 nant or birthing person’s choosing (in ad- 17 dition to a doula or other perinatal health 18 worker) during labor, delivery, and recov- 19 ery; with necessary, evidence based, and 20 non-discriminatory exceptions; 21 ‘‘(ii) to require that such hospital does 22 not implement any policies that restrict 23 hospital access or birthing options for 24 pregnant or birthing persons, unless such 25 policies are necessary, evidence-based, com- 26 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 2598 IH municated to the patient without threat or 1 intimidation, and applied without discrimi- 2 nation on the basis of race, gender iden- 3 tity, socio-economic status, religion, sexual 4 orientation, marital status, age, disability, 5 national origin, and immigration status; 6 and 7 ‘‘(iii) with respect to the care of a 8 pregnant or birthing person, to require the 9 communication of and informed consent 10 (without threat or intimidation) to the im- 11 plementation of policies pursuant to clause 12 (ii) by the pregnant or birthing person, in 13 accordance with consent protocols of the 14 hospital in the case of inability of a person 15 to provide consent.’’. 16 SEC. 3. EXPANDING MEDICARE AND MEDICAID COVERAGE 17 OF TELEHEALTH SERVICES THAT ARE MA- 18 TERNAL HEALTH CARE SERVICES. 19 (a) REMOVAL OF CERTAIN MEDICARE REQUIRE- 20 MENTS FOR MATERNAL HEALTH CARE SERVICES.—Sec- 21 tion 1834(m) of the Social Security Act (42 U.S.C. 22 1395m(m)) is amended— 23 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 2598 IH (1) in paragraph (4)(C)(i), by striking ‘‘para- 1 graphs (5), (6), and (7)’’ and inserting ‘‘paragraphs 2 (5), (6), (7), and (9)’’; and 3 (2) by adding at the end the following new 4 paragraph: 5 ‘‘(9) TREATMENT OF MATERNITY HEALTH 6 CARE SERVICES.—With respect to telehealth services 7 that are maternal health care services, notwith- 8 standing any other provision of this subsection— 9 ‘‘(A) the requirements described in para- 10 graph (4)(C) shall not apply; 11 ‘‘(B) the term ‘originating site’ means sites 12 at which the eligible telehealth individual is lo- 13 cated at the time the service is furnished via a 14 telecommunications system; and 15 ‘‘(C) there shall be no restrictions on ac- 16 cess to such telehealth services through use of 17 telephone based on the use of video capabilities 18 or lack of such capabilities.’’. 19 (b) MEDICAID COVERAGE.—Section 1905(a) of the 20 Social Security Act (42 U.S.C. 1396d(a)) is amended— 21 (1) in paragraph (5)(A), by inserting ‘‘(and in 22 the case of physicians’ services that are maternal 23 health care services, including via telehealth)’’ after 24 ‘‘or elsewhere’’; 25 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 2598 IH (2) in paragraph (17), by inserting ‘‘, including 1 services furnished via telehealth,’’ before ‘‘fur- 2 nished’’; 3 (3) in paragraph (21), by inserting ‘‘, including 4 services furnished via telehealth,’’ after ‘‘furnished’’; 5 and 6 (4) in paragraph (28), by inserting ‘‘, including 7 such services furnished via telehealth to the extent 8 such services may be performed under State law by 9 freestanding birth centers’’ before the semicolon at 10 the end. 11 SEC. 4. ENSURING COVERAGE OF CERTAIN MATERNAL 12 HEALTH CARE SERVICES. 13 (a) MAKING CERTAIN MEDICAID COVERAGE OF CER- 14 TAIN PRENATAL AND POSTPARTUM SERVICES A STATE 15 PLAN REQUIREMENT.— 16 (1) STATE MEDICAID PLANS.— 17 (A) IN GENERAL.—Section 1902 of the So- 18 cial Security Act (42 U.S.C. 1396a) is amend- 19 ed— 20 (i) in subsection (a)— 21 (I) in paragraph (86), by striking 22 ‘‘and’’ at the end; 23 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 2598 IH (II) in paragraph (87), by strik- 1 ing at the end the period and insert- 2 ing ‘‘; and’’; and 3 (III) by inserting after paragraph 4 (87) the following new paragraph: 5 ‘‘(88) provide that the State plan is in compli- 6 ance with subsection (e)(16).’’; and 7 (ii) in subsection (e)(16)— 8 (I) in subparagraph (A), by strik- 9 ing ‘‘At the option of the State, the 10 State plan (or waiver of such State 11 plan) may provide’’ and inserting ‘‘A 12 State plan (or waiver of such State 13 plan) shall provide’’; 14 (II) in subparagraph (B)— 15 (aa) in the matter preceding 16 clause (i), by striking ‘‘by a State 17 making an election under this 18 paragraph’’ and inserting ‘‘under 19 a State plan (or a waiver os such 20 State plan)’’; 21 (bb) in clause (i), by striking 22 at the end ‘‘and’’; 23 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 2598 IH (cc) in clause (ii), by strik- 1 ing the period at the end and in- 2 serting ‘‘; and’’; and 3 (dd) by adding at the end 4 the following new clause: 5 ‘‘(iii) include as pregnancy-related 6 medical assistance a comprehensive num- 7 ber of prenatal appointments and 8 screenings furnished by a maternity care 9 provider (as defined in section 2730(b)(1) 10 of the Public Health Service Act), 11 perinatal health worker (as defined in sec- 12 tion 2730(b)(2) of the Public Health Serv- 13 ice Act), or community-based provider and 14 as postpartum-related medical assistance a 15 full-spectrum of postpartum care furnished 16 by such a provider.’’; and 17 (III) by striking subparagraph 18 (C). 19 (B) NO COST SHARING OR SIMILAR 20 CHARGES FOR CERTAIN SERVICES.—Section 21 1916(a)(2) of the Social Security Act (42 22 U.S.C. 1396o(a)(2)) is amended— 23 (i) in subparagraph (F), by striking at 24 the end ‘‘or’’; 25 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 2598 IH (ii) in subparagraph (G), by striking 1 ‘‘; and’’ and inserting ‘‘; or’’; and 2 (iii) by adding at the end the fol- 3 lowing new subparagraph: 4 ‘‘(H) appointments, screenings, 5 and care required to be included as 6 pregnancy-related and postpartum-re- 7 lated medical assistance under section 8 1902(e)(16)(B)(iii); and’’. 9 (2) APPLYING REQUIREMENT UNDER CHIP.— 10 Section 2107(e)(1)(J) of the Social Security Act (42 11 U.S.C. 1397gg(e)(1)(J)) is amended to read as fol- 12 lows: 13 ‘‘(J) Paragraphs (5) and (16) of section 14 1902(e) (relating to the requirement to provide 15 medical assistance under the State plan or 16 waiver consisting of full benefits during preg- 17 nancy and throughout the 12-month 18 postpartum period under title XIX) such that 19 the provision of assistance under the State child 20 health plan or waiver for targeted low-income 21 children or targeted low-income pregnant 22 women during pregnancy and the 12-month 23 postpartum period shall be required and shall 24 include coverage of all items or services pro- 25 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 2598 IH vided to a targeted low-income child or targeted 1 low-income pregnant woman (as applicable) 2 under the State child health plan or waiver), in- 3 cluding the appointments, screenings, and care 4 required to be included as pregnancy-related 5 and postpartum-related medical assistance 6 under section 1902(e)(16)(B)(iii).’’. 7 (3) EFFECTIVE DATE.— 8 (A) IN GENERAL.—Except as provided in 9 paragraph (2), the amendments made by this 10 section shall take effect on the date of the en- 11 actment of this Act and shall apply to services 12 furnished on or after the date that is 30 days 13 after the date of enactment of this Act. 14 (B) EXCEPTION IF STATE LEGISLATION 15 REQUIRED.—In the case of a State plan for 16 medical assistance under title XIX of the Social 17 Security Act or State child health plan for child 18 health assistance under title XXI of such Act 19 which the Secretary of Health and Human 20 Services determines requires State legislation 21 (other than legislation appropriating funds) in 22 order for the plan to meet the additional re- 23 quirement imposed by the amendments made by 24 this subsection, the State plan or State child 25 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 2598 IH health plan shall not be regarded as failing to 1 comply with the requirements of such title sole- 2 ly on the basis of its failure to meet this addi- 3 tional requirement before the first day of the 4 first calendar quarter beginning after the close 5 of the first regular session of the State legisla- 6 ture that begins after the date of the enactment 7 of this Act. For purposes of the previous sen- 8 tence, in the case of a State that has a 2-year 9 legislative session, each year of such session 10 shall be deemed to be a separate regular session 11 of the State legislature. 12 (b) PRIVATE HEALTH PLANS.—Subpart II of part A 13 of title XXVII of the Public Health Service Act (42 U.S.C. 14 300gg–11 et seq.) is amended by adding at the end the 15 following new section: 16 ‘‘SEC. 2730. COVERAGE OF PRENATAL AND POSTPARTUM 17 SERVICES. 18 ‘‘(a) IN GENERAL.—Beginning 30 days after the date 19 of enactment of this section, a group health plan and a 20 health insurance issuer offering group or individual health 21 insurance coverage shall provide coverage for and shall not 22 impose any cost sharing requirements for— 23 ‘‘(1) a comprehensive number of prenatal ap- 24 pointments and screenings furnished by a maternity 25 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 2598 IH care provider, perinatal health worker, or commu- 1 nity-based provider; and 2 ‘‘(2) a full-spectrum of postpartum care fur- 3 nished by such a provider for at least a year after 4 birth or the end of pregnancy. 5 ‘‘(b) DEFINITIONS.—For purposes of this section: 6 ‘‘(1) MATERNITY CARE PROVIDER.—The term 7 ‘maternity care provider’ means a health care pro- 8 vider who— 9 ‘‘(A) is a physician, physician assistant, or 10 midwife who meets at a minimum the inter- 11 national definition of the midwife and global 12 standards for midwifery education as estab- 13 lished by the International Confederation of 14 Midwives, nurse practitioner, or clinical nurse 15 specialist; and 16 ‘‘(B) has a focus on maternal or perinatal 17 health. 18 ‘‘(2) PERINATAL HEALTH WORKER.—The term 19 ‘perinatal health worker’ means a doula, community 20 health worker, peer supporter, breastfeeding and lac- 21 tation educator or counselor, nutritionist or dieti- 22 tian, childbirth educator, social worker, home visitor, 23 language interpreter, or navigator.’’. 24 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 2598 IH SEC. 5. ENSURING FREE TESTING, VACCINE, AND TREAT- 1 MENT FOR COVID–19 TO PREGNANT PERSONS 2 AND TO INFANTS, REGARDLESS OF INSUR- 3 ANCE STATUS OR SOURCE OF INSURANCE. 4 (a) EXPANSION OF COVERAGE OF TESTING FOR 5 COVID–19 TO OTHER PRIVATE PLANS.—Section 6001(a) 6 of the Families First Coronavirus Response Act (Public 7 Law 116–127) is amended by striking ‘‘A group health 8 plan and a health insurance issuer offering group or indi- 9 vidual health insurance coverage (including a grand- 10 fathered health plan (as defined in section 1251(e) of the 11 Patient Protection and Affordable Care Act))’’ and insert- 12 ing ‘‘A group health plan, a health insurance issuer offer- 13 ing group or individual health insurance coverage (includ- 14 ing a grandfathered health plan (as defined in section 15 1251(e) of the Patient Protection and Affordable Care 16 Act)), short-term limited duration insurance, association 17 health plans and health care sharing ministries’’. 18 (b) REQUIREMENT TO PROVIDE COVERAGE FOR 19 COVID–19 TREATMENT AFTER THE COVID–19 EMER- 20 GENCY PERIOD.— 21 (1) STATE MEDICAID PLANS.— 22 (A) PLANS WITH TRADITIONAL COST 23 SHARING.—Subsections (a)(2)(F) and (b)(2)(F) 24 of section 1916 of the Social Security Act (42 25 U.S.C. 1396o) are each amended by striking 26 VerDate Sep 11 2014 22:39 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H2598.IH H2598 pbinns on DSKJLVW7X2PROD with BILLS 13 •HR 2598 IH ‘‘that is administered during any portion of the 1 emergency period described in such section be- 2 ginning on or after the date of the enactment 3 of this subparagraph (and the administration of 4 such product)’’. 5 (B) PLA [Text truncated for display. 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