MOMS Act

II 117TH CONGRESS 1ST SESSION S. 1333 To address maternal mortality and morbidity. IN THE SENATE OF THE UNITED STATES APRIL 22, 2021 Mrs. GILLIBRAND introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To address maternal mortality and morbidity. 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 ‘‘Modernizing Obstetric 4 Medicine Standards Act of 2021’’ or the ‘‘MOMS Act’’. 5 SEC. 2. MATERNAL MORTALITY AND MORBIDITY PREVEN- 6 TION. 7 Section 317K of the Public Health Service Act (42 8 U.S.C. 247b–12) is amended— 9 (1) by redesignating subsections (e) and (f) as 10 subsections (g) and (h), respectively; and 11 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 2 •S 1333 IS (2) by inserting after subsection (d) the fol- 1 lowing: 2 ‘‘(e) PREGNANCY AND POSTPARTUM SAFETY AND 3 MONITORING PRACTICES AND MATERNAL MORTALITY 4 AND MORBIDITY PREVENTION.— 5 ‘‘(1) ALLIANCE FOR INNOVATION ON MATERNAL 6 HEALTH.—The Secretary, acting through the Asso- 7 ciate Administrator of the Maternal and Child 8 Health Bureau of the Health Resources and Services 9 Administration, shall establish a program, known as 10 the Alliance for Innovation on Maternal Health pro- 11 gram, to— 12 ‘‘(A) enter into a contract with an inter- 13 disciplinary, multi-stakeholder, national organi- 14 zation promulgating a national data-driven ma- 15 ternal safety and quality improvement initiative 16 based on evidence-based best practices to im- 17 prove maternal safety and outcomes; 18 ‘‘(B) assist States with the development 19 and implementation of postpartum safety and 20 monitoring practices and maternal mortality 21 and morbidity prevention, based on the best 22 practices developed under paragraph (2); and 23 ‘‘(C) improve State-specific maternal 24 health outcomes and reduce variation in re- 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 3 •S 1333 IS sponse to maternity and postpartum care, in 1 order to eliminate preventable maternal mor- 2 tality and severe maternal morbidity. 3 ‘‘(2) BEST PRACTICES.— 4 ‘‘(A) IN GENERAL.—Not later than 1 year 5 after the date of enactment of the Modernizing 6 Obstetric Medicine Standards Act of 2021, the 7 Secretary, acting through the Administrator of 8 the Health Resources and Services Administra- 9 tion, shall work with the contracting entity 10 under paragraph (1)(A) to— 11 ‘‘(i) create and assist State-based col- 12 laborative teams in the implementation of 13 standardized best practices, to be known as 14 ‘maternal safety bundles’, for the purpose 15 of maternal mortality and morbidity pre- 16 vention; and 17 ‘‘(ii) collect and analyze data related 18 to process structure and patient outcomes 19 to drive continuous quality improvement in 20 the implementation of the maternal safety 21 bundles by such State-based teams. 22 ‘‘(B) MATERNAL SAFETY BUNDLES.—The 23 best practices issued under subparagraph (A) 24 may address the following topics: 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 4 •S 1333 IS ‘‘(i) Obstetric hemorrhage. 1 ‘‘(ii) Maternal mental, behavioral, and 2 emotional health. 3 ‘‘(iii) Maternal venous and thrombo- 4 embolism. 5 ‘‘(iv) Severe hypertension in preg- 6 nancy, including preeclampsia. 7 ‘‘(v) Obstetric care for women with 8 substance abuse disorder. 9 ‘‘(vi) Postpartum care basics for ma- 10 ternal safety. 11 ‘‘(vii) Reduction of racial and ethnic 12 disparities in maternity care. 13 ‘‘(viii) Safe reduction of primary ce- 14 sarean birth. 15 ‘‘(ix) Severe maternal morbidity re- 16 view. 17 ‘‘(x) Support after a severe maternal 18 morbidity event. 19 ‘‘(xi) Ways to empower and listen to 20 women before, during, and after childbirth 21 to ensure better communication between 22 patients and health care providers. 23 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 5 •S 1333 IS ‘‘(xii) Other leading causes of mater- 1 nal mortality and morbidity, including in- 2 fection or sepsis and cardiomyopathy. 3 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 4 To carry out this subsection, in addition to amounts 5 appropriated under subsection (h), there are author- 6 ized to be appropriated $5,000,000 for each of fiscal 7 years 2022 through 2026.’’. 8 SEC. 3. MATERNAL MORTALITY AND MORBIDITY PREVEN- 9 TION GRANTS. 10 Section 317K of the Public Health Service Act (42 11 U.S.C. 247b–12), as amended by section 2, is further 12 amended— 13 (1) by inserting after subsection (e) the fol- 14 lowing: 15 ‘‘(f) MATERNAL MORTALITY AND MORBIDITY PRE- 16 VENTION GRANT PROGRAM.— 17 ‘‘(1) IN GENERAL.—The Secretary, acting 18 through the Associate Administrator of the Maternal 19 and Child Health Bureau of the Health Resources 20 and Services Administration, shall award grants to 21 States or hospitals to assist in the development and 22 implementation of the maternal safety bundles de- 23 scribed in subsection (e)(2). 24 ‘‘(2) USE OF FUNDS.— 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 6 •S 1333 IS ‘‘(A) IN GENERAL.—A State or hospital re- 1 ceiving a grant under this subsection may use 2 such funds— 3 ‘‘(i) to purchase equipment and sup- 4 plies to effectively implement and execute 5 the maternal safety bundles described in 6 subsection (e)(2); and 7 ‘‘(ii) to develop training on, and eval- 8 uation of the effectiveness of, such mater- 9 nal safety bundles. 10 ‘‘(B) PRIORITY USE OF FUNDS FOR STATE 11 GRANTEES.—A State receiving a grant under 12 this subsection shall allocate such funds giving 13 priority to the hospitals in such State that serve 14 high volumes of low-income, at-risk, or rural 15 populations. 16 ‘‘(3) PRIORITIZATION OF GRANT APPLICA- 17 TIONS.—In awarding grants under this subsection, 18 the Secretary shall prioritize applications from 19 States, or hospitals within States, that— 20 ‘‘(A) have a functioning maternal mortality 21 review committee in accordance with best prac- 22 tices promulgated by the Building U.S. Capac- 23 ity to Review and Prevent Maternal Deaths Ini- 24 tiative of the Centers for Disease Control and 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 7 •S 1333 IS Prevention, the CDC Foundation, and the Asso- 1 ciation of Maternal and Child Health Programs, 2 or as described in subsection (d)(1); or 3 ‘‘(B) serve high volumes of low-income, at- 4 risk, or rural populations. 5 ‘‘(4) REPORTING REQUIREMENTS.— 6 ‘‘(A) IN GENERAL.—Not later than 2 years 7 after receipt of a grant under this subsection, 8 each recipient of such a grant shall submit a re- 9 port to the Secretary describing— 10 ‘‘(i) implementation of the maternal 11 safety bundles with use of the grant funds; 12 ‘‘(ii) any incidents of pregnancy-re- 13 lated deaths or pregnancy-associated 14 deaths, and any pregnancy-related com- 15 plications or pregnancy-associated com- 16 plications occurring in the 1-year period 17 prior to implementation of such proce- 18 dures; and 19 ‘‘(iii) any incidents of pregnancy-re- 20 lated deaths or pregnancy-associated 21 deaths, and any pregnancy-related com- 22 plications or pregnancy-associated com- 23 plications occurring after implementation 24 of such procedures. 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 8 •S 1333 IS ‘‘(B) PUBLIC AVAILABILITY; REPORT TO 1 CONGRESS.—Within 1 year of receiving the re- 2 ports under subparagraph (A), the Secretary 3 shall— 4 ‘‘(i) make the reports submitted under 5 subparagraph (A) publicly available; and 6 ‘‘(ii) submit a report to Congress that 7 describes the grants awarded under this 8 subsection, the effectiveness of the grant 9 program under this subsection, the activi- 10 ties for which grant funds were used, and 11 any recommendations to further prevent 12 maternal mortality and morbidity. 13 ‘‘(C) AUTHORIZATION OF APPROPRIA- 14 TIONS.—To carry out this subsection, in addi- 15 tion to amounts appropriated under subsection 16 (h), there are authorized to be appropriated 17 $40,000,000 for each of fiscal years 2022 18 through 2026.’’; and 19 (2) in subsection (g), as so redesignated by sec- 20 tion 2(1), by striking paragraphs (2) and (3) and in- 21 serting the following: 22 ‘‘(2) the terms ‘pregnancy-associated death’ and 23 ‘pregnancy-associated complication’ mean the death 24 or medical complication, respectively, of a woman 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 9 •S 1333 IS that occurs during, or within 1 year following, her 1 pregnancy, regardless of the outcome, duration, or 2 site of the pregnancy; 3 ‘‘(3) the terms ‘pregnancy-related death’ and 4 ‘pregnancy-related complication’ mean the death or 5 medical complication, respectively, of a woman 6 that— 7 ‘‘(A) occurs during, or within 1 year fol- 8 lowing, her pregnancy, regardless of the out- 9 come, duration, or site of the pregnancy; 10 ‘‘(B) is from any cause related to, or ag- 11 gravated by, the pregnancy or its management; 12 and 13 ‘‘(C) is not from an accidental or inci- 14 dental cause; and 15 ‘‘(4) the term ‘severe maternal morbidity’ 16 means the unexpected outcomes of labor and deliv- 17 ery that result in significant short- or long-term con- 18 sequences to a woman’s health.’’. 19 SEC. 4. REPORTING ON PREGNANCY-RELATED AND PREG- 20 NANCY-ASSOCIATED DEATHS AND COMPLICA- 21 TIONS. 22 (a) IN GENERAL.—The Secretary of Health and 23 Human Services shall encourage each State to voluntarily 24 submit to the Secretary each year a report containing the 25 VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS 10 •S 1333 IS findings of a State maternal mortality review committee 1 with respect to each maternal death in the State that the 2 committee reviewed during the year. 3 (b) MATERNAL AND INFANT HEALTH.—The Director 4 of the Centers for Disease Control and Prevention shall— 5 (1) update the Pregnancy Mortality Surveil- 6 lance System or develop a separate system so that 7 such system is capable of including data obtained 8 from State maternal mortality review committees; 9 and 10 (2) provide technical assistance to States in re- 11 viewing cases of pregnancy-related complications and 12 pregnancy-associated complications. 13 (c) DEFINITIONS.—In this section, the terms ‘‘preg- 14 nancy-associated complication’’ and ‘‘pregnancy-related 15 complication’’ have the meanings given such terms in sec- 16 tion 317K of the Public Health Service Act, as amended 17 by section 3. 18 Æ VerDate Sep 11 2014 00:43 May 21, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\S1333.IS S1333 pbinns on DSKJLVW7X2PROD with BILLS