IMPACT to Save Moms Act

II 118TH CONGRESS 1ST SESSION S. 1797 To establish a demonstration program to allow States to test payment models for maternity care provided under Medicaid and the Children’s Health Insurance Program. IN THE SENATE OF THE UNITED STATES JUNE 1, 2023 Mr. CASEY (for himself, Mr. BOOKER, and Mr. MENENDEZ) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To establish a demonstration program to allow States to test payment models for maternity care provided under Medicaid and the Children’s Health Insurance Program. 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 ‘‘IMPACT to Save 4 Moms Act’’. 5 SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL 6 DEMONSTRATION PROJECT. 7 (a) IN GENERAL.—For the period of fiscal years 8 2024 through 2028, the Secretary of Health and Human 9 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1797 IS Services (referred to in this section as the ‘‘Secretary’’), 1 acting through the Administrator of the Centers for Medi- 2 care & Medicaid Services, shall establish and implement, 3 in accordance with the requirements of this section, a 4 demonstration project, to be known as the Perinatal Care 5 Alternative Payment Model Demonstration Project (re- 6 ferred to in this section as the ‘‘Demonstration Project’’), 7 for purposes of allowing States to test payment models 8 under their State plans under title XIX of the Social Secu- 9 rity Act (42 U.S.C. 1396 et seq.) and State child health 10 plans under title XXI of such Act (42 U.S.C. 1397aa et 11 seq.) with respect to maternity care provided to pregnant 12 and postpartum individuals enrolled in such State plans 13 and State child health plans. 14 (b) COORDINATION.—In establishing the Demonstra- 15 tion Project, the Secretary shall coordinate with stake- 16 holders such as— 17 (1) State Medicaid programs; 18 (2) maternity care providers and organizations 19 representing maternity care providers; 20 (3) relevant organizations representing patients, 21 with a particular focus on patients from demo- 22 graphic groups with elevated rates of maternal mor- 23 tality, severe maternal morbidity, maternal health 24 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1797 IS disparities, or other adverse perinatal or childbirth 1 outcomes; 2 (4) relevant community-based organizations, 3 particularly organizations that seek to improve ma- 4 ternal health outcomes for individuals from demo- 5 graphic groups with elevated rates of maternal mor- 6 tality, severe maternal morbidity, maternal health 7 disparities, or other adverse perinatal or childbirth 8 outcomes; 9 (5) perinatal health workers; 10 (6) relevant health insurance issuers; 11 (7) hospitals, health systems, midwifery prac- 12 tices, freestanding birth centers (as such term is de- 13 fined in paragraph (3)(B) of section 1905(l) of the 14 Social Security Act (42 U.S.C. 1396d(l))), Feder- 15 ally-qualified health centers (as such term is defined 16 in paragraph (2)(B) of such section), and rural 17 health clinics (as such term is defined in section 18 1861(aa) of such Act (42 U.S.C. 1395x(aa))); 19 (8) researchers and policy experts in fields re- 20 lated to maternity care payment models; and 21 (9) any other stakeholders as the Secretary de- 22 termines appropriate, with a particular focus on 23 stakeholders from demographic groups with elevated 24 rates of maternal mortality, severe maternal mor- 25 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1797 IS bidity, maternal health disparities, or other adverse 1 perinatal or childbirth outcomes. 2 (c) CONSIDERATIONS.—In establishing the Dem- 3 onstration Project, the Secretary shall consider any alter- 4 native payment model that— 5 (1) is designed to improve maternal health out- 6 comes for individuals from demographic groups with 7 elevated rates of maternal mortality, severe maternal 8 morbidity, maternal health disparities, or other ad- 9 verse perinatal or childbirth outcomes; 10 (2) includes methods for stratifying patients by 11 pregnancy risk level and, as appropriate, adjusting 12 payments under such model to take into account 13 pregnancy risk level, including consideration of the 14 appropriate transfer of patients by pregnancy risk 15 level; 16 (3) establishes evidence-based quality metrics 17 for such payments; 18 (4) includes consideration of nonhospital birth 19 settings such as freestanding birth centers (as so de- 20 fined); 21 (5) includes consideration of social deter- 22 minants of maternal health; 23 (6) includes diverse maternity care teams that 24 include— 25 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1797 IS (A) maternity care providers, mental and 1 behavioral health care providers acting in ac- 2 cordance with State law, and registered dieti- 3 tians or nutrition professionals (as such term is 4 defined in section 1861(vv)(2) of the Social Se- 5 curity Act (42 U.S.C. 1395x(vv)(2)))— 6 (i) from racially, ethnically, and pro- 7 fessionally diverse backgrounds; 8 (ii) with experience practicing in ra- 9 cially and ethnically diverse communities; 10 or 11 (iii) who have undergone training on 12 implicit bias and racism; and 13 (B) perinatal health workers; or 14 (7) includes consideration of maternal mental 15 health conditions and substance use disorders. 16 (d) ELIGIBILITY.—To be eligible to participate in the 17 Demonstration Project, a State shall submit an applica- 18 tion to the Secretary at such time, in such manner, and 19 containing such information as the Secretary may require. 20 (e) EVALUATION.—The Secretary shall conduct an 21 evaluation of the Demonstration Project to determine the 22 impact of the Demonstration Project on— 23 (1) maternal health outcomes, with data strati- 24 fied by race, ethnicity, primary language, socio- 25 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1797 IS economic status, geography, insurance type, and 1 other factors as the Secretary determines appro- 2 priate; 3 (2) spending on maternity care by States par- 4 ticipating in the Demonstration Project; 5 (3) to the extent practicable, qualitative and 6 quantitative measures of patient experience; and 7 (4) any other areas of assessment that the Sec- 8 retary determines relevant. 9 (f) REPORT.—Not later than one year after the com- 10 pletion or termination date of the Demonstration Project, 11 the Secretary shall submit to the Congress, and make pub- 12 licly available, a report containing— 13 (1) the results of any evaluation conducted 14 under subsection (e); and 15 (2) a recommendation regarding whether the 16 Demonstration Project should be continued after fis- 17 cal year 2028 and expanded on a national basis. 18 (g) AUTHORIZATION OF APPROPRIATIONS.—There 19 are authorized to be appropriated such sums as are nec- 20 essary to carry out this section. 21 (h) DEFINITIONS.—In this section: 22 (1) ALTERNATIVE PAYMENT MODEL.—The 23 term ‘‘alternative payment model’’ has the meaning 24 VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1797 IS given such term in section 1833(z)(3)(C) of the So- 1 cial Security Act (42 U.S.C. 1395l(z)(3)(C)). 2 (2) PERINATAL.—The term ‘‘perinatal’’ means 3 the period beginning on the day an individual be- 4 comes pregnant and ending on the last day of the 5 1-year period beginning on the last day of such indi- 6 vidual’s pregnancy. 7 Æ VerDate Sep 11 2014 01:00 Jun 17, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6301 E:\BILLS\S1797.IS S1797 kjohnson on DSK79L0C42PROD with BILLS