MOMS Act of 2021

I 117TH CONGRESS 1ST SESSION H. R. 3688 To address maternal mortality and morbidity. IN THE HOUSE OF REPRESENTATIVES JUNE 4, 2021 Ms. ADAMS introduced the following bill; which was referred to the Committee on Energy and Commerce 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 of 5 2021’’. 6 SEC. 2. MATERNAL MORTALITY AND MORBIDITY PREVEN- 7 TION. 8 (a) PREGNANCY AND POSTPARTUM SAFETY AND 9 MONITORING PRACTICES AND MATERNAL MORTALITY 10 AND MORBIDITY PREVENTION.—Section 317K of the 11 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 3688 IH Public Health Service Act (42 U.S.C. 247b–12) is amend- 1 ed— 2 (1) by redesignating subsections (d) through (f) 3 as subsections (f) through (h), respectively; 4 (2) in subsection (a)(2)(D), by striking ‘‘sub- 5 section (d)’’ and inserting ‘‘subsection (f)’’; and 6 (3) by inserting after subsection (c) the fol- 7 lowing: 8 ‘‘(d) PREGNANCY AND POSTPARTUM SAFETY AND 9 MONITORING PRACTICES AND MATERNAL MORTALITY 10 AND MORBIDITY PREVENTION.— 11 ‘‘(1) ALLIANCE FOR INNOVATION ON MATERNAL 12 HEALTH.—The Secretary, acting through the Asso- 13 ciate Administrator of the Maternal and Child 14 Health Bureau of the Health Resources and Services 15 Administration, shall establish a program, known as 16 the Alliance for Innovation on Maternal Health pro- 17 gram, to— 18 ‘‘(A) enter into a contract with an inter- 19 disciplinary, multi-stakeholder, national organi- 20 zation promulgating a national data-driven ma- 21 ternal safety and quality improvement initiative 22 based on evidence-based best practices to im- 23 prove maternal safety and outcomes; 24 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 3688 IH ‘‘(B) assist States with the development 1 and implementation of postpartum safety and 2 monitoring practices and maternal mortality 3 and morbidity prevention, based on the best 4 practices developed under paragraph (2); and 5 ‘‘(C) improve State-specific maternal 6 health outcomes and reduce variation in re- 7 sponse to maternity and postpartum care, in 8 order to eliminate preventable maternal mor- 9 tality and severe maternal morbidity. 10 ‘‘(2) BEST PRACTICES.— 11 ‘‘(A) IN GENERAL.—Not later than 1 year 12 after the date of enactment of the Modernizing 13 Obstetric Medicine Standards Act of 2021, the 14 Secretary, acting through the Administrator of 15 the Health Resources and Services Administra- 16 tion, shall work with the contracting entity 17 under paragraph (1)(A) to— 18 ‘‘(i) create and assist State-based col- 19 laborative teams in the implementation of 20 standardized best practices, to be known as 21 ‘maternal safety bundles’, for the purpose 22 of maternal mortality and morbidity pre- 23 vention; and 24 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 3688 IH ‘‘(ii) collect and analyze data related 1 to process structure and patient outcomes 2 to drive continuous quality improvement in 3 the implementation of the maternal safety 4 bundles by such State-based teams. 5 ‘‘(B) MATERNAL SAFETY BUNDLES.—The 6 best practices issued under subparagraph (A) 7 may address the following topics: 8 ‘‘(i) Obstetric hemorrhage. 9 ‘‘(ii) Maternal mental, behavioral, and 10 emotional health. 11 ‘‘(iii) Maternal venous and thrombo- 12 embolism. 13 ‘‘(iv) Severe hypertension in preg- 14 nancy, including preeclampsia. 15 ‘‘(v) Obstetric care for women with 16 substance abuse disorder. 17 ‘‘(vi) Postpartum care basics for ma- 18 ternal safety. 19 ‘‘(vii) Reduction of racial and ethnic 20 disparities in maternity care. 21 ‘‘(viii) Safe reduction of primary ce- 22 sarean birth. 23 ‘‘(ix) Severe maternal morbidity re- 24 view. 25 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 3688 IH ‘‘(x) Support after a severe maternal 1 morbidity event. 2 ‘‘(xi) Ways to empower and listen to 3 women before, during, and after childbirth 4 to ensure better communication between 5 patients and health care providers. 6 ‘‘(xii) Other leading causes of mater- 7 nal mortality and morbidity, including in- 8 fection or sepsis and cardiomyopathy. 9 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 10 To carry out this subsection, in addition to amounts 11 appropriated under subsection (g), there are author- 12 ized to be appropriated $5,000,000 for each of fiscal 13 years 2022 through 2026.’’. 14 (b) MATERNAL MORTALITY AND MORBIDITY PRE- 15 VENTION GRANTS.—Section 317K of the Public Health 16 Service Act (42 U.S.C. 247b–12), as amended by sub- 17 section (a), is further amended by inserting after sub- 18 section (d) the following: 19 ‘‘(e) MATERNAL MORTALITY AND MORBIDITY PRE- 20 VENTION GRANT PROGRAM.— 21 ‘‘(1) IN GENERAL.—The Secretary, acting 22 through the Associate Administrator of the Maternal 23 and Child Health Bureau of the Health Resources 24 and Services Administration, shall award grants to 25 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 3688 IH States or hospitals to assist in the development and 1 implementation of the maternal safety bundles de- 2 scribed in subsection (d)(2). 3 ‘‘(2) USE OF FUNDS.— 4 ‘‘(A) IN GENERAL.—A State or hospital re- 5 ceiving a grant under this subsection may use 6 such funds— 7 ‘‘(i) to purchase equipment and sup- 8 plies to effectively implement and execute 9 the maternal safety bundles described in 10 subsection (d)(2); and 11 ‘‘(ii) to develop training on, and eval- 12 uation of the effectiveness of, such mater- 13 nal safety bundles. 14 ‘‘(B) PRIORITY USE OF FUNDS FOR STATE 15 GRANTEES.—A State receiving a grant under 16 this subsection shall allocate such funds giving 17 priority to the hospitals in such State that serve 18 high volumes of low-income, at-risk, or rural 19 populations. 20 ‘‘(3) PRIORITIZATION OF GRANT APPLICA- 21 TIONS.—In awarding grants under this subsection, 22 the Secretary shall prioritize applications from 23 States, or hospitals within States, that— 24 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 3688 IH ‘‘(A) have a functioning maternal mortality 1 review committee in accordance with best prac- 2 tices promulgated by the Building U.S. Capac- 3 ity to Review and Prevent Maternal Deaths Ini- 4 tiative of the Centers for Disease Control and 5 Prevention, the CDC Foundation, and the Asso- 6 ciation of Maternal and Child Health Programs; 7 or 8 ‘‘(B) serve high volumes of low-income, at- 9 risk, or rural populations. 10 ‘‘(4) REPORTING REQUIREMENTS.— 11 ‘‘(A) IN GENERAL.—Not later than 2 years 12 after receipt of a grant under this subsection, 13 each recipient of such a grant shall submit a re- 14 port to the Secretary describing— 15 ‘‘(i) implementation of the maternal 16 safety bundles with use of the grant funds; 17 ‘‘(ii) any incidents of pregnancy-re- 18 lated deaths or pregnancy-associated 19 deaths, and any pregnancy-related com- 20 plications or pregnancy-associated com- 21 plications occurring in the 1-year period 22 prior to implementation of such proce- 23 dures; and 24 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 3688 IH ‘‘(iii) any incidents of pregnancy-re- 1 lated deaths or pregnancy-associated 2 deaths, and any pregnancy-related com- 3 plications or pregnancy-associated com- 4 plications occurring after implementation 5 of such procedures. 6 ‘‘(B) PUBLIC AVAILABILITY; REPORT TO 7 CONGRESS.—Within 1 year of receiving the re- 8 ports under subparagraph (A), the Secretary 9 shall— 10 ‘‘(i) make the reports submitted under 11 subparagraph (A) publicly available; and 12 ‘‘(ii) submit a report to Congress that 13 describes the grants awarded under this 14 subsection, the effectiveness of the grant 15 program under this subsection, the activi- 16 ties for which grant funds were used, and 17 any recommendations to further prevent 18 maternal mortality and morbidity. 19 ‘‘(C) AUTHORIZATION OF APPROPRIA- 20 TIONS.—To carry out this subsection, in addi- 21 tion to amounts appropriated under subsection 22 (g), there are authorized to be appropriated 23 $40,000,000 for each of fiscal years 2022 24 through 2026.’’. 25 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 3688 IH (c) DEFINITIONS.—Subsection (g) of section 317K of 1 the Public Health Service Act (42 U.S.C. 247b–12), as 2 redesignated by subsection (a)(1), is amended to read as 3 follows: 4 ‘‘(g) DEFINITIONS.—In this section: 5 ‘‘(1) The terms ‘Indian tribe’ and ‘tribal organi- 6 zation’ have the meanings given such terms in sec- 7 tion 4 of the Indian Self-Determination and Edu- 8 cation Assistance Act. 9 ‘‘(2) The terms ‘pregnancy-associated death’ 10 and ‘pregnancy-associated complication’ mean the 11 death or medical complication, respectively, of a 12 woman that occurs during, or within 1 year fol- 13 lowing, her pregnancy, regardless of the outcome, 14 duration, or site of the pregnancy. 15 ‘‘(3) The terms ‘pregnancy-related death’ and 16 ‘pregnancy-related complication’ mean the death or 17 medical complication, respectively, of a woman 18 that— 19 ‘‘(A) occurs during, or within 1 year fol- 20 lowing, her pregnancy, regardless of the out- 21 come, duration, or site of the pregnancy; 22 ‘‘(B) is from any cause related to, or ag- 23 gravated by, the pregnancy or its management; 24 and 25 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 3688 IH ‘‘(C) is not from an accidental or inci- 1 dental cause. 2 ‘‘(4) The term ‘severe maternal morbidity’ 3 means the unexpected outcomes of labor and deliv- 4 ery that result in significant short- or long-term con- 5 sequences to a woman’s health.’’. 6 SEC. 3. REPORTING ON PREGNANCY-RELATED AND PREG- 7 NANCY-ASSOCIATED DEATHS AND COMPLICA- 8 TIONS. 9 (a) IN GENERAL.—The Secretary of Health and 10 Human Services shall encourage each State to voluntarily 11 submit to the Secretary each year a report containing the 12 findings of a State maternal mortality review committee 13 with respect to each maternal death in the State that the 14 committee reviewed during the year. 15 (b) MATERNAL AND INFANT HEALTH.—The Director 16 of the Centers for Disease Control and Prevention shall— 17 (1) update the Pregnancy Mortality Surveil- 18 lance System or develop a separate system so that 19 such system is capable of including data obtained 20 from State maternal mortality review committees; 21 and 22 (2) provide technical assistance to States in re- 23 viewing cases of pregnancy-related complications and 24 pregnancy-associated complications. 25 VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 3688 IH (c) DEFINITIONS.—In this section, the terms ‘‘preg- 1 nancy-associated complication’’ and ‘‘pregnancy-related 2 complication’’ have the meanings given such terms in sec- 3 tion 317K of the Public Health Service Act, as amended 4 by section 2. 5 Æ VerDate Sep 11 2014 22:47 Jul 23, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6301 E:\BILLS\H3688.IH H3688 pbinns on DSKJLVW7X2PROD with BILLS