Quality Care for Moms and Babies Act

II 116TH CONGRESS 1ST SESSION S. 1960 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 SENATE OF THE UNITED STATES JUNE 25, 2019 Ms. STABENOW (for herself and Ms. COLLINS) introduced the following bill; which was read twice and referred to the Committee on Finance 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 (b) TABLE OF CONTENTS.—The table of contents for 6 this Act is as follows: 7 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 2 •S 1960 IS 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 1 HEALTH. 2 (a) IN GENERAL.—Title XI of the Social Security Act 3 (42 U.S.C. 1301 et seq.) is amended by inserting after 4 section 1139B the following new section: 5 ‘‘SEC. 1139C. MATERNAL AND INFANT QUALITY MEASURES. 6 ‘‘(a) DEVELOPMENT OF CORE SET OF HEALTH CARE 7 QUALITY MEASURES FOR MATERNAL AND INFANT 8 HEALTH.— 9 ‘‘(1) IN GENERAL.—The Secretary shall iden- 10 tify and publish a recommended core set of maternal 11 and infant health quality measures for women and 12 children described in subparagraphs (A) and (B) of 13 section 1902(l)(1) in the same manner as the Sec- 14 retary identifies and publishes a core set of child 15 health quality measures under section 1139A, in- 16 cluding with respect to identifying and publishing 17 existing maternal and infant health quality measures 18 that are in use under public and privately sponsored 19 health care coverage arrangements, or that are part 20 of reporting systems that measure both the presence 21 and duration of health insurance coverage over time, 22 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 3 •S 1960 IS that may be applicable to Medicaid and CHIP eligi- 1 ble mothers and infants. 2 ‘‘(2) ALIGNMENT WITH EXISTING CORE SETS.— 3 In identifying and publishing the recommended core 4 set of maternal and infant health quality measures 5 required under paragraph (1), the Secretary shall 6 ensure that, to the extent possible, such measures 7 align with and do not duplicate— 8 ‘‘(A) the core set of child health quality 9 measures identified, published, and revised 10 under section 1139A; or 11 ‘‘(B) the core set of adult health quality 12 measures identified, published, and revised 13 under section 1139B. 14 ‘‘(3) PROCESS FOR MATERNAL AND INFANT 15 QUALITY MEASURES PROGRAM.—In identifying gaps 16 in existing maternal and infant measures and estab- 17 lishing priorities for the development and advance- 18 ment of such measures, the Secretary shall consult 19 with— 20 ‘‘(A) States; 21 ‘‘(B) physicians, including physicians in 22 the fields of general obstetrics, maternal-fetal 23 medicine, family medicine, neonatology, and pe- 24 diatrics; 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 4 •S 1960 IS ‘‘(C) nurse practitioners and nurses; 1 ‘‘(D) certified nurse-midwives and certified 2 midwives; 3 ‘‘(E) health facilities and health systems; 4 ‘‘(F) national organizations representing 5 mothers and infants; 6 ‘‘(G) national organizations representing 7 consumers and purchasers of health care; 8 ‘‘(H) national organizations and individ- 9 uals with expertise in maternal and infant 10 health quality measurement; and 11 ‘‘(I) voluntary consensus standard-setting 12 organizations and other organizations involved 13 in the advancement of evidence-based measures 14 of health care. 15 ‘‘(b) DEADLINES.— 16 ‘‘(1) RECOMMENDED MEASURES.—Not later 17 than January 1, 2021, the Secretary shall identify 18 and publish for comment a recommended core set of 19 maternal and infant health quality measures that in- 20 cludes the following: 21 ‘‘(A) Measures of the process, experience, 22 efficiency, and outcomes of maternity care, in- 23 cluding postpartum outcomes. 24 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 5 •S 1960 IS ‘‘(B) Measures that apply to childbearing 1 women and newborns at healthy, low, and high 2 risk, including measures of low-intervention 3 birth. 4 ‘‘(C) Measures that apply to care during 5 pregnancy, the intrapartum period, and the 6 postpartum period. 7 ‘‘(D) Measures that apply to a variety of 8 settings and provider types, such as clinics, fa- 9 cilities, health plans, and accountable care orga- 10 nizations. 11 ‘‘(E) Measures that address disparities, 12 care coordination, and shared decisionmaking. 13 ‘‘(2) DISSEMINATION.—Not later than January 14 1, 2022, the Secretary shall publish an initial core 15 set of maternal and infant health quality measures 16 that are applicable to Medicaid and CHIP eligible 17 mothers and infants. 18 ‘‘(3) STANDARDIZED REPORTING.—Not later 19 than January 1, 2023, the Secretary, in consultation 20 with States, shall develop a standardized format for 21 reporting information based on the initial core set of 22 maternal and infant health quality measures and 23 create procedures to encourage States to use such 24 measures to voluntarily report information regarding 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 6 •S 1960 IS the quality of health care for Medicaid and CHIP el- 1 igible mothers and infants. 2 ‘‘(4) REPORTS TO CONGRESS.—Not later than 3 January 1, 2024, and every 3 years thereafter, the 4 Secretary shall include in the report to Congress re- 5 quired under section 1139A(a)(6) information simi- 6 lar to the information required under that section 7 with respect to the measures established under this 8 section. 9 ‘‘(5) ESTABLISHMENT OF MATERNAL AND IN- 10 FANT QUALITY MEASUREMENT PROGRAM.— 11 ‘‘(A) IN GENERAL.—Not later than 12 12 months after the release of the recommended 13 core set of maternal and infant health quality 14 measures under paragraph (1), the Secretary 15 shall establish a Maternal and Infant Quality 16 Measurement Program in the same manner as 17 the Secretary established the pediatric quality 18 measures program under section 1139A(b). 19 ‘‘(B) REVISING, STRENGTHENING, AND IM- 20 PROVING INITIAL CORE MEASURES.—Beginning 21 not later than 24 months after the establish- 22 ment of the Maternal and Infant Quality Meas- 23 urement Program, and annually thereafter, the 24 Secretary shall publish recommended changes 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 7 •S 1960 IS to the initial core set of maternal and infant 1 health quality measures that shall reflect the 2 results of the testing, validation, and consensus 3 process for the development of maternal and in- 4 fant health quality measures. 5 ‘‘(C) EMEASURES.— 6 ‘‘(i) IN GENERAL.—An entity awarded 7 a grant or contract by the Secretary to de- 8 velop emerging and innovative evidence- 9 based measures under the Maternal and 10 Infant Quality Measurement Program shall 11 work to advance eMeasures that are 12 aligned with the measures developed under 13 the Pediatric Quality Measures Program 14 established under section 1139A(b) and 15 the Medicaid Quality Measurement Pro- 16 gram established under section 17 1139B(b)(5). 18 ‘‘(ii) DEFINITION.—For purposes of 19 this subparagraph, the term ‘eMeasure’ 20 means an electronic measure for which 21 measurement data (including clinical data) 22 will be collected electronically, including 23 through the use of electronic health 24 records and other electronic data sources. 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 8 •S 1960 IS ‘‘(D) AMOUNT AVAILABLE FOR GRANTS 1 AND CONTRACTS.—The aggregate amount of 2 funds that may be awarded as grants and con- 3 tracts under the Maternal and Infant Quality 4 Measurement Program for the development, 5 testing, and validation of emerging and innova- 6 tive evidence-based measures shall not exceed 7 the aggregate amount of funds awarded as 8 grants and contracts under section 9 1139A(b)(4)(A). 10 ‘‘(c) CONSTRUCTION.—Nothing in this section shall 11 be construed as supporting the restriction of coverage, 12 under title XIX or XXI or otherwise, to only those services 13 that are evidence-based, or in any way limiting available 14 services. 15 ‘‘(d) MATERNITY CONSUMER ASSESSMENT OF 16 HEALTH CARE PROVIDERS AND SYSTEMS SURVEYS.— 17 ‘‘(1) ADAPTION OF SURVEYS.—Not later than 18 January 1, 2022, for the purpose of measuring the 19 care experiences of childbearing women and 20 newborns, where appropriate, the Agency for 21 Healthcare Research and Quality shall adapt Con- 22 sumer Assessment of Healthcare Providers and Sys- 23 tems program surveys of— 24 ‘‘(A) providers; 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 9 •S 1960 IS ‘‘(B) facilities; and 1 ‘‘(C) health plans. 2 ‘‘(2) SURVEYS MUST BE EFFECTIVE.—The 3 Agency for Healthcare Research and Quality shall 4 ensure that the surveys adapted under paragraph 5 (1) are effective in measuring aspects of care that 6 childbearing women and newborns experience, which 7 may include— 8 ‘‘(A) various types of care settings; 9 ‘‘(B) various types of caregivers; 10 ‘‘(C) considerations relating to pain; 11 ‘‘(D) shared decisionmaking; 12 ‘‘(E) supportive care around the time of 13 birth; and 14 ‘‘(F) other topics relevant to the quality of 15 the experience of childbearing women and 16 newborns. 17 ‘‘(3) LANGUAGES.—The surveys adapted under 18 paragraph (1) shall be available in English and 19 Spanish. 20 ‘‘(4) ENDORSEMENT.—The Agency for Health- 21 care Research and Quality shall submit any Con- 22 sumer Assessment of Healthcare Providers and Sys- 23 tems surveys adapted under this paragraph to the 24 consensus-based entity with a contract under section 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 10 •S 1960 IS 1890(a)(1) to be considered for endorsement under 1 section 1890(b)(2). 2 ‘‘(5) CONSULTATION.—The adaption of (and 3 process for applying) the surveys under paragraph 4 (1) shall be conducted in consultation with the 5 stakeholders identified in paragraph (6)(A). 6 ‘‘(6) STAKEHOLDERS.— 7 ‘‘(A) IN GENERAL.—The stakeholders 8 identified in this subparagraph are— 9 ‘‘(i) the various clinical disciplines and 10 specialties involved in providing maternity 11 care; 12 ‘‘(ii) State Medicaid administrators; 13 ‘‘(iii) maternity care consumers and 14 their advocates; 15 ‘‘(iv) technical experts in quality 16 measurement; 17 ‘‘(v) hospital, facility, and health sys- 18 tem leaders; 19 ‘‘(vi) employers and purchasers; and 20 ‘‘(vii) other individuals who are in- 21 volved in the advancement of evidence- 22 based maternity care quality measures. 23 ‘‘(B) PROFESSIONAL ORGANIZATIONS.— 24 The stakeholders identified under subparagraph 25 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 11 •S 1960 IS (A) may include representatives from relevant 1 national medical specialty and professional or- 2 ganizations and specialty societies. 3 ‘‘(e) ANNUAL STATE REPORTS REGARDING STATE- 4 SPECIFIC MATERNAL AND INFANT QUALITY OF CARE 5 MEASURES APPLIED UNDER MEDICAID OR CHIP.— 6 ‘‘(1) IN GENERAL.—Each State with a plan or 7 waiver approved under title XIX or XXI shall annu- 8 ally report (separately or as part of the annual re- 9 port required under section 1139A(c)) to the Sec- 10 retary on— 11 ‘‘(A) the State-specific maternal and infant 12 health quality measures applied by the State 13 under such plan or waiver, including measures 14 described in subsection (b)(5)(B); and 15 ‘‘(B) the State-specific information on the 16 quality of health care furnished to Medicaid and 17 CHIP eligible mothers and infants under such 18 plan or waiver, including information collected 19 through external quality reviews of managed 20 care organizations under section 1932 and 21 benchmark plans under section 1937. 22 ‘‘(2) PUBLICATION.—Not later than September 23 30, 2024, and annually thereafter, the Secretary 24 VerDate Sep 11 2014 04:15 Jun 28, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S1960.IS S1960 kjohnson on DSK79L0C42 with BILLS 12 •S 1960 IS shall collect, analyze, and make publicly available the 1 information reported by States under paragraph (1). 2 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 3 are authorized to be appropriated $16,000,000 to carry 4 out this section. Funds appropriated under this subsection 5 shall remain available until expended.’’. 6 (b) TECHNICAL AMENDMENT.—Section 7 1139B(d)(1)(A) of the Social Security Act (42 U.S.C. 8 1320b–9b(d)(1)(A)) is amended by striking ‘‘subsection 9 (a)(5)’’ and inserting ‘‘subsection (b)(5)’’. 10 SEC. 3. QUALITY COLLABORATIVES. 11 (a) GRANTS.—The Secretary of Health and Human 12 Services (in this section referred to as the Secretary) may 13 make grants to eligible entities to support— 14 (1) the development of new State and regional 15 maternity and infant care quality collaboratives; 16 (2) expanded activities of existing maternity 17 and infant care quality collaboratives; and 18 (3) maternity and infant care initiatives within 19 established State and regional quality collaboratives 20 that are not focused exclusively on maternity care. 21 (b) ELIGIBLE ENTITY.—The following en [Text truncated for display. Full text available on Congress.gov.]