Quality Care for Moms and Babies Act

I 116TH CONGRESS 1ST SESSION H. R. 1551 To amend title XI of the Social Security Act to improve the quality, health outcomes, and value of maternity care under the Medicaid and CHIP programs by developing maternity care quality measures and supporting maternity care quality collaboratives. IN THE HOUSE OF REPRESENTATIVES MARCH 6, 2019 Mr. ENGEL (for himself and Mr. STIVERS) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provi- sions as fall within the jurisdiction of the committee concerned A BILL To amend title XI of the Social Security Act to improve the quality, health outcomes, and value of maternity care under the Medicaid and CHIP programs by devel- oping maternity care quality measures and supporting maternity care quality collaboratives. 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; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Quality Care for Moms and Babies Act’’. 5 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 2 •HR 1551 IH (b) TABLE OF CONTENTS.—The table of contents for 1 this Act is as follows: 2 Sec. 1. Short title; table of contents. Sec. 2. Quality measures for maternal and infant health. Sec. 3. Quality collaboratives. Sec. 4. Facilitation of increased coordination and alignment between the public and private sector with respect to quality and efficiency meas- ures. SEC. 2. QUALITY MEASURES FOR MATERNAL AND INFANT 3 HEALTH. 4 (a) IN GENERAL.—Title XI of the Social Security Act 5 (42 U.S.C. 1301 et seq.) is amended by inserting after 6 section 1139B the following new section: 7 ‘‘SEC. 1139C. MATERNAL AND INFANT QUALITY MEASURES. 8 ‘‘(a) DEVELOPMENT OF CORE SET OF HEALTH CARE 9 QUALITY MEASURES FOR MATERNAL AND INFANT 10 HEALTH.— 11 ‘‘(1) IN GENERAL.—The Secretary shall iden- 12 tify and publish a recommended core set of maternal 13 and infant health quality measures for women and 14 children described in subparagraphs (A) and (B) of 15 section 1902(l)(1) in the same manner as the Sec- 16 retary identifies and publishes a core set of child 17 health quality measures under section 1139A, in- 18 cluding with respect to identifying and publishing 19 existing maternal and infant health quality measures 20 that are in use under public and privately sponsored 21 health care coverage arrangements, or that are part 22 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 3 •HR 1551 IH of reporting systems that measure both the presence 1 and duration of health insurance coverage over time, 2 that may be applicable to Medicaid and CHIP eligi- 3 ble mothers and infants. 4 ‘‘(2) ALIGNMENT WITH EXISTING CORE SETS.— 5 In identifying and publishing the recommended core 6 set of maternal and infant health quality measures 7 required under paragraph (1), the Secretary shall 8 ensure that, to the extent possible, such measures 9 align with and do not duplicate— 10 ‘‘(A) the core set of child health quality 11 measures identified, published, and revised 12 under section 1139A; or 13 ‘‘(B) the core set of adult health quality 14 measures identified, published, and revised 15 under section 1139B. 16 ‘‘(3) PROCESS FOR MATERNAL AND INFANT 17 QUALITY MEASURES PROGRAM.—In identifying gaps 18 in existing maternal and infant measures and estab- 19 lishing priorities for the development and advance- 20 ment of such measures, the Secretary shall consult 21 with— 22 ‘‘(A) States; 23 ‘‘(B) physicians, including physicians in 24 the fields of general obstetrics, maternal-fetal 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 4 •HR 1551 IH medicine, family medicine, neonatology, and pe- 1 diatrics; 2 ‘‘(C) nurse practitioners and nurses; 3 ‘‘(D) certified nurse-midwives and certified 4 midwives; 5 ‘‘(E) health facilities and health systems; 6 ‘‘(F) national organizations representing 7 mothers and infants; 8 ‘‘(G) national organizations representing 9 consumers and purchasers of health care; 10 ‘‘(H) national organizations and individ- 11 uals with expertise in maternal and infant 12 health quality measurement; and 13 ‘‘(I) voluntary consensus standard-setting 14 organizations and other organizations involved 15 in the advancement of evidence-based measures 16 of health care. 17 ‘‘(b) DEADLINES.— 18 ‘‘(1) RECOMMENDED MEASURES.—Not later 19 than January 1, 2021, the Secretary shall identify 20 and publish for comment a recommended core set of 21 maternal and infant health quality measures that in- 22 cludes the following: 23 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 5 •HR 1551 IH ‘‘(A) Measures of the process, experience, 1 efficiency, and outcomes of maternity care, in- 2 cluding postpartum outcomes. 3 ‘‘(B) Measures that apply to childbearing 4 women and newborns at healthy, low, and high 5 risk, including measures of low-intervention 6 birth. 7 ‘‘(C) Measures that apply to care during 8 pregnancy, the intrapartum period, and the 9 postpartum period. 10 ‘‘(D) Measures that apply to a variety of 11 settings and provider types, such as clinics, fa- 12 cilities, health plans, and accountable care orga- 13 nizations. 14 ‘‘(E) Measures that address disparities, 15 care coordination, and shared decisionmaking. 16 ‘‘(2) DISSEMINATION.—Not later than January 17 1, 2022, the Secretary shall publish an initial core 18 set of maternal and infant health quality measures 19 that are applicable to Medicaid and CHIP eligible 20 mothers and infants. 21 ‘‘(3) STANDARDIZED REPORTING.—Not later 22 than January 1, 2023, the Secretary, in consultation 23 with States, shall develop a standardized format for 24 reporting information based on the initial core set of 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 6 •HR 1551 IH maternal and infant health quality measures and 1 create procedures to encourage States to use such 2 measures to voluntarily report information regarding 3 the quality of health care for Medicaid and CHIP el- 4 igible mothers and infants. 5 ‘‘(4) REPORTS TO CONGRESS.—Not later than 6 January 1, 2024, and every 3 years thereafter, the 7 Secretary shall include in the report to Congress re- 8 quired under section 1139A(a)(6) information simi- 9 lar to the information required under that section 10 with respect to the measures established under this 11 section. 12 ‘‘(5) ESTABLISHMENT OF MATERNAL AND IN- 13 FANT QUALITY MEASUREMENT PROGRAM.— 14 ‘‘(A) IN GENERAL.—Not later than 12 15 months after the release of the recommended 16 core set of maternal and infant health quality 17 measures under paragraph (1), the Secretary 18 shall establish a Maternal and Infant Quality 19 Measurement Program in the same manner as 20 the Secretary established the pediatric quality 21 measures program under section 1139A(b). 22 ‘‘(B) REVISING, STRENGTHENING, AND IM- 23 PROVING INITIAL CORE MEASURES.—Beginning 24 not later than 24 months after the establish- 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 7 •HR 1551 IH ment of the Maternal and Infant Quality Meas- 1 urement Program, and annually thereafter, the 2 Secretary shall publish recommended changes 3 to the initial core set of maternal and infant 4 health quality measures that shall reflect the 5 results of the testing, validation, and consensus 6 process for the development of maternal and in- 7 fant health quality measures. 8 ‘‘(C) EMEASURES.— 9 ‘‘(i) IN GENERAL.—An entity awarded 10 a grant or contract by the Secretary to de- 11 velop emerging and innovative evidence- 12 based measures under the Maternal and 13 Infant Quality Measurement Program shall 14 work to advance eMeasures that are 15 aligned with the measures developed under 16 the Pediatric Quality Measures Program 17 established under section 1139A(b) and 18 the Medicaid Quality Measurement Pro- 19 gram established under section 20 1139B(b)(5). 21 ‘‘(ii) DEFINITION.—For purposes of 22 this subparagraph, the term ‘eMeasure’ 23 means an electronic measure for which 24 measurement data (including clinical data) 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 8 •HR 1551 IH will be collected electronically, including 1 through the use of electronic health 2 records and other electronic data sources. 3 ‘‘(D) AMOUNT AVAILABLE FOR GRANTS 4 AND CONTRACTS.—The aggregate amount of 5 funds that may be awarded as grants and con- 6 tracts under the Maternal and Infant Quality 7 Measurement Program for the development, 8 testing, and validation of emerging and innova- 9 tive evidence-based measures shall not exceed 10 the aggregate amount of funds awarded as 11 grants and contracts under section 12 1139A(b)(4)(A). 13 ‘‘(c) CONSTRUCTION.—Nothing in this section shall 14 be construed as supporting the restriction of coverage, 15 under title XIX or XXI or otherwise, to only those services 16 that are evidence based, or in any way limiting available 17 services. 18 ‘‘(d) MATERNITY CONSUMER ASSESSMENT OF 19 HEALTH CARE PROVIDERS AND SYSTEMS SURVEYS.— 20 ‘‘(1) ADAPTION OF SURVEYS.—Not later than 21 January 1, 2022, for the purpose of measuring the 22 care experiences of childbearing women and 23 newborns, where appropriate, the Agency for 24 Healthcare Research and Quality shall adapt Con- 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 9 •HR 1551 IH sumer Assessment of Healthcare Providers and Sys- 1 tems program surveys of— 2 ‘‘(A) providers; 3 ‘‘(B) facilities; and 4 ‘‘(C) health plans. 5 ‘‘(2) SURVEYS MUST BE EFFECTIVE.—The 6 Agency for Healthcare Research and Quality shall 7 ensure that the surveys adapted under paragraph 8 (1) are effective in measuring aspects of care that 9 childbearing women and newborns experience, which 10 may include— 11 ‘‘(A) various types of care settings; 12 ‘‘(B) various types of caregivers; 13 ‘‘(C) considerations relating to pain; 14 ‘‘(D) shared decisionmaking; 15 ‘‘(E) supportive care around the time of 16 birth; and 17 ‘‘(F) other topics relevant to the quality of 18 the experience of childbearing women and 19 newborns. 20 ‘‘(3) LANGUAGES.—The surveys adapted under 21 paragraph (1) shall be available in English and 22 Spanish. 23 ‘‘(4) ENDORSEMENT.—The Agency for Health- 24 care Research and Quality shall submit any Con- 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 10 •HR 1551 IH sumer Assessment of Healthcare Providers and Sys- 1 tems surveys adapted under this paragraph to the 2 consensus-based entity with a contract under section 3 1890(a)(1) to be considered for endorsement under 4 section 1890(b)(2). 5 ‘‘(5) CONSULTATION.—The adaption of (and 6 process for applying) the surveys under paragraph 7 (1) shall be conducted in consultation with the 8 stakeholders identified in paragraph (6)(A). 9 ‘‘(6) STAKEHOLDERS.— 10 ‘‘(A) IN GENERAL.—The stakeholders 11 identified in this subparagraph are— 12 ‘‘(i) the various clinical disciplines and 13 specialties involved in providing maternity 14 care; 15 ‘‘(ii) State Medicaid administrators; 16 ‘‘(iii) maternity care consumers and 17 their advocates; 18 ‘‘(iv) technical experts in quality 19 measurement; 20 ‘‘(v) hospital, facility and health sys- 21 tem leaders; 22 ‘‘(vi) employers and purchasers; and 23 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 11 •HR 1551 IH ‘‘(vii) other individuals who are in- 1 volved in the advancement of evidence- 2 based maternity care quality measures. 3 ‘‘(B) PROFESSIONAL ORGANIZATIONS.— 4 The stakeholders identified under subparagraph 5 (A) may include representatives from relevant 6 national medical specialty and professional or- 7 ganizations and specialty societies. 8 ‘‘(e) ANNUAL STATE REPORTS REGARDING STATE- 9 SPECIFIC MATERNAL AND INFANT QUALITY OF CARE 10 MEASURES APPLIED UNDER MEDICAID OR CHIP.— 11 ‘‘(1) IN GENERAL.—Each State with a plan or 12 waiver approved under title XIX or XXI shall annu- 13 ally report (separately or as part of the annual re- 14 port required under section 1139A(c)) to the Sec- 15 retary on— 16 ‘‘(A) the State-specific maternal and infant 17 health quality measures applied by the State 18 under such plan or waiver, including measures 19 described in subsection (b)(5)(B); and 20 ‘‘(B) the State-specific information on the 21 quality of health care furnished to Medicaid and 22 CHIP eligible mothers and infants under such 23 plan or waiver, including information collected 24 through external quality reviews of managed 25 VerDate Sep 11 2014 22:29 Mar 20, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551 pbinns on DSK79D2C42PROD with BILLS 12 •HR 1551 IH care organizations under section 1932 and 1 benchmark plans under section 1937. 2 ‘‘(2) PUBLICATION.—Not later than September 3 30, 2024, and annually thereafter, the Secretary 4 shall collect, analyze, and make publicly available the 5 information reported by States under paragraph (1). 6 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 7 are authorized to be appropriated $16,000,000 to carry 8 out this section. Funds appropriated under this subsection 9 shall remain available until expended.’’. 10 (b) TECHNICAL AMENDMENT.—Section 11 1139B(d)(1)(A) of the Social Security Act (42 U.S.C. 12 1320b–9b(d)(1)(A)) is amended by striking ‘‘subsection 13 (a)(5)’’ and inserting ‘‘subsection (b)(5)’’. 14 SEC. 3. QUALITY COLLABORATIVES. 15 (a) GRANTS.—The Secretary of Health and Human 16 Services (in this section referred to as the Secretary) may 17 make grants to eligible entities to support— 18 (1) the development of new State and regional 19 maternity and infant care quality collaboratives; 20 (2) expanded activities of existing maternity 21 a [Text truncated for display. Full text available on Congress.gov.]