,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #bfjb  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #h1 #bjai,ms4    
,pressley 7= h]self1 ,ms4 ,adams1 & ,ms4
 ,und]wood7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce  ,a ,,bill  ,to am5d titles    
,,xix & ,,xxi ( ! ,social ,security ,act
 to improve ,m$icaid & ! ,*ildr5's      
,heal? ,insurance ,program = l[-income  
mo!rs4  #a4 ,%ort title ,?is ,act may be
 cit$ z ! ,heal?y ,,mommies ,act4  #b4  
,enhanc+ ,m$icaid & ,,*ip b5efits =     
l[-income pregnant wom5  7a7 ,ext5d+    
cont9u\s ,m$icaid & ,,*ip cov]age =     
pregnant & po/p>tum wom5  7#a7 ,m$icaid 
,title ,,xix ( ! ,social ,security ,act 
7#db ,u4,s4,c4 #acif et seq47 is am5d$--
  7,a7 9 section #aijb7l77#a77;,a71 by  
/rik+ #fj-;day p]iod & ins]t+ #cfe-;day 
p]iod2  7,b7 9 section #aijb7;e77#f71 by
 /rik+ #fj-;day p]iod & ins]t+ #cfe-;day
 p]iod2  7,c7 9 section                 
#aijc7v77#d77;,a77i71 by /rik+ #fj-;day 
p]iod & ins]t+ #cfe-;day p]iod2 &  7,d7 

9 section #aije7;a71 9 ! #d? s5t5ce 9 ! 
matt] foll[+ p>agraph 7#cj71 by /rik+   
#fj-;day p]iod & ins]t+ #cfe-;day p]iod4
  7#b7 ,,*ip ,section #baab ( ! ,social 
,security ,act 7#db ,u4,s4,c4 #acigll7  
is am5d$ by /rik+ #fj-;day p]iod ea*    
place x appe>s & ins]t+ #cfe-;day p]iod4
  7b7 ,requir+ full b5efits = pregnant &
 po/p>tum wom5  7#a7 ,m$icaid  7,a7 ,9  
g5]al ,p>agraph 7#e7 ( section #aijb7;e7
 ( ! ,social ,security ,act 7#bd        
,u4,s4,c4 #acif;a7e77 is am5d$ to read z
 foll[s3  7#e7 ,any woman :o is eligible
 = m$ical assi/ance "u ! ,/ate plan or a
 waiv] ( su* plan & :o is1 or :o :ile s 
eligible becomes1 pregnant1 %all cont9ue
 to be eligible "u ! plan or waiv] =    
m$ical assi/ance ?r\gh ! end ( ! mon? 9 
:i* ! #cfe-;day p]iod 7beg9n+ on ! la/  
day ( h] pregnancy7 ends1 reg>dless ( ! 
basis = ! woman's eligibility = m$ical  
assi/ance1 includ+ if ! woman's         
eligibility = m$ical assi/ance is on !  
basis ( be+ pregnant4  4  7,b7 ,con=m+  
am5dm5t ,section #aijb7;a77#aj7 ( !     

,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#aj77 is am5d$ 9 ! matt]     
foll[+ subp>agraph 7,g7 by /rik+ 7,,vii7
 ! m$ical assi/ance & all t foll[s ?r\gh
 complicate pregnancy14  7#b7 ,,*ip     
,section #bajg7;e77#a7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#acig;gg7e77#a77 is am5d$-- 7,a7 by     
r$esignat+ subp>agraphs 7,h7 ?r\gh 7,s7 
z subp>agraphs 7,i7 ?r\gh 7,t71         
respectively2 &  7,b7 by ins]t+ aft]    
subp>agraph 7,g71 ! foll[+3  7,h7       
,section #aijb7;e77#e7 7requir+         
#cfe-;day cont9u\s cov]age = pregnant & 
po/p>tum wom574  4  7c7 ,requir+ cov]age
 ( oral heal? s]vices = pregnant &      
po/p>tum wom5  7#a7 ,m$icaid ,section   
#aije ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acif;d7 is am5d$-- 7,a7 9    
subsection 7a77#d7--  7i7 by /rik+ 2 &  
7,d7 & ins]t+ 2 7,d72 &  7ii7 by ins]t+ 
2 & 7,e7 oral heal? s]vices = pregnant &
 po/p>tum wom5 7z def9$ 9 subsection    
7ff77 aft] subsection 7bb772 &  7,b7 by 
add+ at ! end ! foll[+ new subsection3  

7ff7 ,oral heal? s]vices = pregnant &   
po/p>tum wom5  7#a7 ,9 g5]al ,= purposes
 ( ?is title1 ! t]m oral heal? s]vices =
 pregnant & po/p>tum wom5 means d5tal   
s]vices necess>y to prev5t disease &    
promote oral heal?1 re/ore oral         
/ructures to heal? & function1 & treat  
em]g5cy conditions t are furni%$ to a   
woman dur+ pregnancy 7or dur+ !         
#cfe-;day p]iod beg9n+ on ! la/ day ( ! 
pregnancy74  7#b7 ,cov]age requirem5ts  
,to satisfy ! requirem5t to provide oral
 heal? s]vices = pregnant & po/p>tum    
wom51 a ,/ate %all1 at a m9imum1 provide
 cov]age = prev5tive1 diagno/ic1        
p]iodontal1 & re/orative c>e consi/5t ) 
recomm5dations = p]9atal oral heal? c>e 
& d5tal c>e dur+ pregnancy f ! ,am]ican 
,academy ( ,p$iatric ,d5ti/ry & !       
,am]ican ,college ( ,ob/etricians &     
,gynecologi/s4  4  7#b7 ,,*ip ,section  
#bajc7;c77#e77;,a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acig;cc7c77#e77;,a77 is am5d$ by ins]t+
 or a t>get$ l[-income pregnant woman   

aft] t>get$ l[-income *ild4  7d7        
,ma9t5ance ( ef=t  7#a7 ,m$icaid        
,section #aijb ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 
7,a7 9 p>agraph 7#gd71 by /rik+         
subsection 7gg72 & & ins]t+ subsections 
7gg7 & 7qq722 &  7,b7 by add+ at ! end !
 foll[+ new subsection3  7qq7 ,ma9t5ance
 ( ef=t relat$ to l[-,income pregnant   
wom5 ,= cal5d> qu>t]s beg9n+ on or aft] 
! date ( enactm5t ( ?is subsection1 &   
be=e ,janu>y #a1 #bjbc1 no ,f$]al paym5t
 %all be made to a ,/ate "u section     
#aijc7;a7 = am\nts exp5d$ "u a ,/ate    
plan "u ?is title or a waiv] ( su* plan 
if ! ,/ate--  7#a7 has 9 effect "u su*  
plan eligibility /&>ds1 me?odologies1 or
 proc$ures 7includ+ any enrollm5t cap or
 o!r num]ical limitation on enrollm5t1  
any wait+ li/1 any proc$ures design$ to 
delay ! consid]ation ( applications =   
enrollm5t1 or simil> limitation )       
respect to enrollm5t7 = individuals     
describ$ 9 subsection 7l77#a7 :o are    
eligible = m$ical assi/ance "u ! ,/ate  

plan or waiv] "u subsection             
7a77#aj77;,a77ii77,,ix7 t are m         
re/rictive ?an ! eligibility /&>ds1     
me?odologies1 or proc$ures1             
respectively1 = su* individuals "u su*  
plan or waiv] t are 9 effect on ! date (
 ! enactm5t ( ! ,heal?y ,,mommies ,act2 
or  7#b7 provides m$ical assi/ance to   
individuals describ$ 9 subsection       
7l77#a7 :o are eligible = m$ical        
assi/ance "u su* plan or waiv] "u       
subsection 7a77#aj77;,a77ii77,,ix7 at a 
level t is less ?an ! level at :i* !    
,/ate provides su* assi/ance to su*     
individuals "u su* plan or waiv] on !   
date ( ! enactm5t ( ! ,heal?y ,,mommies 
,act4  4  7#b7 ,,*ip ,section #baab ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acigll71 z am5d$ by subsection 7b71 is 
fur!r am5d$ by add+ at ! end ! foll[+   
subsection3  7g7 ,ma9t5ance ( ef=t ,=   
cal5d> qu>t]s beg9n+ on or aft] ,janu>y 
#a1 #bjbj1 & be=e ,janu>y #a1 #bjbc1 no 
paym5t may be made "u section #baje7;a7 
) respect to a ,/ate *ild heal? plan if 

! ,/ate--  7#a7 has 9 effect "u su* plan
 eligibility /&>ds1 me?odologies1 or    
proc$ures 7includ+ any enrollm5t cap or 
o!r num]ical limitation on enrollm5t1   
any wait+ li/1 any proc$ures design$ to 
delay ! consid]ation ( applications =   
enrollm5t1 or simil> limitation )       
respect to enrollm5t7 = t>get$ l[-income
 pregnant wom5 t are m re/rictive ?an ! 
eligibility /&>ds1 me?odologies1 or     
proc$ures1 respectively1 "u su* plan t  
are 9 effect on ! date ( ! enactm5t ( ! 
,heal?y ,,mommies ,act2 or  7#b7        
provides pregnancy-relat$ assi/ance to  
t>get$ l[-income pregnant wom5 "u su*   
plan at a level t is less ?an ! level at
 :i* ! ,/ate provides su* assi/ance to  
su* wom5 "u su* plan on ! date ( !      
enactm5t ( ! ,heal?y ,,mommies ,act4  4 
7e7 ,enhanc$ ,,fmap ,section #aije ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d71 z am5d$ by subsection 7c71 is 
fur!r am5d$--  7#a7 9 subsection 7b71 by
 /rik+ & 7aa7 & ins]t+ 7aa71 & 7gg72 &  
7#b7 by add+ at ! end ! foll[+3  7gg7   

,increas$ ,,fmap = additional           
exp5ditures = l[-,income pregnant wom5  
,= cal5d> qu>t]s beg9n+ on or aft]      
,janu>y #a1 #bjbj1 not)/&+ subsection   
7b71 ! ,f$]al m$ical assi/ance p]c5tage 
= a ,/ate1 ) respect to ! additional    
am\nts exp5d$ by su* ,/ate = m$ical     
assi/ance "u ! ,/ate plan "u ?is title  
or a waiv] ( su* plan t are attributable
 to requirem5ts impos$ by ! am5dm5ts    
made by ! ,heal?y ,,mommies ,act 7z     
det]m9$ by ! ,secret>y71 %all be equal  
to #ajj p]c5t4  4  7f7 ,,gao /udy &     
report  7#a7 ,9 g5]al ,n lat] ?an #a ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,comptroll] ,g5]al ( ! ,unit$ ,/ates    
%all submit to ,congress a report on !  
gaps 9 cov]age =--  7,a7 pregnant wom5  
"u ! ,m$icaid program "u title ,,xix ( !
 ,social ,security ,act 7#db ,u4,s4,c4  
#acif et seq47 & ! ,*ildr5's ,heal?     
,insurance ,program "u title ,,xxi ( !  
,social ,security ,act 7#db ,u4,s4,c4   
#acig;aa et seq472 &  7,b7 po/p>tum wom5
 "u ! ,m$icaid program & ! ,*ildr5's    

,heal? ,insurance ,program :o receiv$   
assi/ance "u ei!r su* program dur+ _!   
pregnancy4  7#b7 ,cont5t ( report ,!    
report requir$ "u ?is subsection %all   
include ! foll[+3 7,a7 ,in=mation ab\t !
 abilities & successes ( ,/ate ,m$icaid 
ag5cies 9 det]m9+ :e!r pregnant &       
po/p>tum wom5 are eligible "u ano!r     
insurance af=dability program1 & 9      
transition+ any su* wom5 :o are s       
eligible to cov]age "u su* a program1   
pursuant to section #dce4abjj ( ! title 
#db1 ,code ( ,f$]al ,regulations 7z 9   
effect on ,septemb] #a1 #bjah74  7,b7   
,in=mation on factors contribut+ to gaps
 9 cov]age t disproportionately impact  
und]s]v$ populations1 includ+ l[-income 
wom51 wom5 ( color1 wom5 :o reside 9 a  
heal? pr(essional %ortage area 7z def9$ 
9 section #ccb7;a77#a77;,a7 ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#bed;e7a77#a77;,a777 or :o are memb]s ( 
a m$ically und]s]v$ population 7z def9$ 
by section #ccj7;b77#c7 ( su* ,act 7#db 
,u4,s4,c4 #bed;b7b77#c77;,a7774  7,c7   

,recomm5dations = address+ & r$uc+ su*  
gaps 9 cov]age4  7,d7 ,su* o!r in=mation
 z ! ,comptroll] ,g5]al deems necess>y4 
7g7 ,effective date ,! am5dm5ts made by 
subsections 7a7 & 7b7 %all take effect  
,janu>y #a1 #bjbj4  #c4 ,mat]nity c>e   
home demon/ration project ,title ,,xix (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acif et seq47 is am5d$ by ins]t+ !    
foll[+ new section aft] section #aidf3  
#aidg4 ,mat]nity c>e home demon/ration  
project  7a7 ,9 g5]al ,n lat] ?an #a ye>
 aft] ! date ( ! enactm5t ( ?is section1
 ! ,secret>y %all e/abli% a demon/ration
 project 79 ?is section ref]r$ to z !   
demon/ration project7 "u :i* ! ,secret>y
 %all provide grants to ,/ates to ent]  
into arrangem5ts ) eligible entities to 
implem5t or exp& a mat]nity c>e home    
model = eligible individuals4  7b7      
,def9itions ,9 ?is section3 7#a7        
,eligible entity ,! t]m eligible entity 
means an entity or organization t       
provides m$ically accurate1 compreh5sive
 mat]nity s]vices to individuals :o are 

eligible = m$ical assi/ance "u a ,/ate  
plan "u ?is title or a waiv] ( su* a    
plan1 & may include3  7,a7 ,a free/&+   
bir? c5t]4  7,b7 ,an entity or          
organization receiv+ assi/ance "u       
section #ccj ( ! ,public ,heal? ,s]vice 
,act4  7,c7 ,a f$]ally qualifi$ heal?   
c5t]4  7,d7 ,a rural heal? cl9ic4  7,e7 
,a heal? facility op]at$ by an ,indian  
tribe or tribal organization 7z ^? t]ms 
are def9$ 9 section #d ( ! ,indian      
,heal? ,c>e ,improvem5t ,act74  7#b7    
,eligible individual ,! t]m eligible    
individual means a pregnant woman or a  
=m]ly pregnant woman dur+ ! #cfe-;day   
p]iod beg9n+ on ! la/ day ( h] pregnancy
 :o is--  7,a7 enroll$ 9 a ,/ate plan "u
 ?is title1 a waiv] ( su* a plan1 or a  
,/ate *ild heal? plan "u title ,,xxi2 & 
7,b7 a pati5t ( an eligible entity :i*  
has ent]$ into an arrangem5t ) a ,/ate  
"u subsection 7g74  7c7 ,goals (        
demon/ration project ,! goals ( !       
demon/ration project are ! foll[+3 7#a7 
,to improve--  7,a7 mat]nity & infant   

c>e outcomes2  7,b7 heal? equity2  7,c7 
communication by mat]nity1 infant c>e1 &
 social s]vices provid]s2  7,d7         
integration ( p]9atal support s]vices1  
includ+ community heal? work]s1 d\las1  
social work]s1 public heal? nurses1 pe] 
lactation c\nselors1 *ildbir? educators1
 & o!rs1 into heal? c>e entities &      
organizations2  7,e7 c>e coord9ation    
betwe5 mat]nity1 infant c>e1 oral heal? 
c>e1 & social s]vices provid]s )9 !     
community2  7,f7 ! quality & safety (   
mat]nity & infant c>e2  7,g7 ! exp]i5ce 
( wom5 receiv+ mat]nity c>e1 includ+ by 
increas+ ! ability ( a woman to develop 
& foll[ h] own bir?+ plan2 &  7,h7      
access to adequate pr5atal & po/p>tum   
c>e1 includ+-- 7i7 pr5atal c>e t is     
initiat$ 9 a timely mann]2  7ii7 n few] 
?an #b po/-pregnancy visits to a        
mat]nity c>e provid]2 &  7iii7          
int]pregnancy c>e4  7#b7 ,to provide    
coord9at$1 evid5ce-bas$ mat]nity c>e    
managem5t4  7#c7 ,to decrease--  7,a7   
sev]e mat]nal morbidity & mat]nal       

mortality2  7,b7 ov]all heal? c>e sp5d+2
  7,c7 unnecess>y em]g5cy dep>tm5t      
visits2  7,d7 disp>ities 9 mat]nal &    
infant c>e outcomes1 includ+ racial1    
economic1 & geographical disp>ities2    
7,e7 racial bias among heal? c>e        
pr(essionals2  7,f7 ! rate ( ces>ean    
deliv]ies = l[-risk pregnancies2  7,g7 !
 rate ( pret]m bir?s & infants born ) l[
 bir? weight2 &  7,h7 ! rate ( avoidable
 mat]nal & newborn hospitalizations &   
admissions to int5sive c>e units4  7d7  
,consultation ,9 design+ & implem5t+ !  
demon/ration project ! ,secret>y %all   
consult ) /akehold]s1 includ+--  7#a7   
,/ates2  7#b7 organizations repres5t+   
relevant heal? c>e pr(essionals1 includ+
 oral heal? c>e pr(essionals2  7#c7     
organizations repres5t+ consum]s1       
includ+ consum]s t are                  
disproportionately impact$ by poor      
mat]nal heal? outcomes2  7#d7           
repres5tatives ) exp]i5ce implem5t+ o!r 
mat]nity c>e home models1 includ+       
repres5tatives f ! ,c5t] = ,m$ic>e &    

,m$icaid ,innovation2  7#e7             
community-bas$ heal? c>e pr(essionals1  
includ+ d\las1 & o!r /akehold]s2 &  7#f7
 exp]ts 9 promot+ heal? equity & combat+
 racial bias 9 heal? c>e sett+s4  7e7   
,application & selection ( ,/ates  7#a7 
,9 g5]al ,a ,/ate seek+ to p>ticipate 9 
! demon/ration project %all submit an   
application to ! ,secret>y at su* "t & 9
 su* mann] z ! ,secret>y %all require4  
7#b7 ,selection ( ,/ates  7,a7 ,9 g5]al 
,! ,secret>y may select #ae ,/ates to   
p>ticipate 9 ! demon/ration project4    
7,b7 ,selection requirem5ts ,9 select+  
,/ates to p>ticipate 9 ! demon/ration   
project1 ! ,secret>y %all--  7i7 ensure 
t !re is geographic div]sity 9 ! areas 9
 :i* activities w be c>ri$ out "u !     
project2 &  7ii7 ensure t ,/ates )      
significant disp>ities 9 mat]nal &      
infant heal? outcomes1 includ+ sev]e    
mat]nal morbidity1 & o!r disp>ities bas$
 on race1 income1 or access to mat]nity 
c>e1 are includ$4  7f7 ,grants  7#a7 ,9 
g5]al ,f am\nts appropriat$ "u          

subsection 7l71 ! ,secret>y %all aw>d #a
 grant = ea* ye> ( ! demon/ration       
project to ea* ,/ate t is select$ to    
p>ticipate 9 ! demon/ration project4    
7#b7 ,use ( grant funds ,a ,/ate may use
 funds receiv$ "u ?is section to-- 7,a7 
aw>d grants or make paym5ts to eligible 
entities z "p ( an arrangem5t describ$ 9
 subsection 7g77#b72  7,b7 provide      
f9ancial inc5tives to heal? c>e         
pr(essionals1 includ+ community heal?   
work]s & community-bas$ d\las1 :o       
p>ticipate 9 ! ,/ate's mat]nity c>e home
 model2  7,c7 provide adequate tra9+ =  
heal? c>e pr(essionals1 includ+         
community heal? work]s1 d\las1 & c>e    
coord9ators1 :o p>ticipate 9 ! ,/ate's  
mat]nity c>e home model1 :i* may include
 tra9+ = cultural compet5cy1 racial     
bias1 heal? equity1 reproductive & bir? 
ju/ice1 home visit+ skills1 & respectful
 communication & li/5+ skills1          
p>ticul>ly 9 reg>ds to mat]nal heal?2   
7,d7 pay = p]sonnel & adm9i/rative      
exp5ses associat$ ) design+1 implem5t+1 

& op]at+ ! ,/ate's mat]nity c>e home    
model2  7,e7 pay = items & s]vices t are
 furni%$ "u ! ,/ate's mat]nity c>e home 
model & = :i* paym5t is o!rwise         
unavailable "u ?is title2 &  7,f7 pay = 
o!r co/s relat$ to ! ,/ate's mat]nity   
c>e home model1 z det]m9$ by !          
,secret>y4  7#c7 ,grant = national      
indep5d5t evaluator  7,a7 ,9 g5]al ,f ! 
am\nts appropriat$ "u subsection 7l71   
prior to aw>d+ any grants "u p>agraph   
7#a71 ! ,secret>y %all ent] into a      
contract ) a national ext]nal entity to 
create a s+le1 uni=m process to--  7i7  
ensure t ,/ates t receive grants "u     
p>agraph 7#a7 comply ) ! requirem5ts (  
?is section2 &  7ii7 evaluate ! outcomes
 ( ! demon/ration project 9 ea*         
p>ticipat+ ,/ate4  7,b7 ,annual report  
,! contract describ$ 9 subp>agraph 7,a7 
%all require ! national ext]nal entity  
to submit to ! ,secret>y--  7i7 a ye>ly 
evaluation report = ea* ye> ( !         
demon/ration project2 &  7ii7 a f9al    
impact report aft] ! demon/ration       

project has conclud$4  7,c7 ,secret>y's 
au?ority ,no?+ 9 ?is p>agraph %all      
prev5t ! ,secret>y f mak+ a det]m9ation 
t a ,/ate is n 9 compliance ) !         
requirem5ts ( ?is section )\t ! national
 ext]nal entity mak+ su* a det]m9ation4 
7g7 ,p>tn]%ip ) eligible entities  7#a7 
,9 g5]al ,z a condition ( receiv+ a     
grant "u ?is section1 a ,/ate %all ent] 
into an arrangem5t ) "o or m eligible   
entities t meets ! requirem5ts (        
p>agraph 7#b74  7#b7 ,arrangem5ts )     
eligible entities ,"u an arrangem5t     
betwe5 a ,/ate & an eligible entity "u  
?is subsection1 ! eligible entity %all  
p]=m ! foll[+ functions1 ) respect to   
eligible individuals enroll$ ) ! entity 
"u ! ,/ate's mat]nity c>e home model--  
7,a7 provide culturally compet5t c>e1   
:i* may include pr5atal c>e1 family     
plann+ s]vices1 m$ical c>e1 m5tal &     
behavioral c>e1 po/p>tum c>e1 & oral    
heal? c>e to su* eligible individuals   
?r\gh a team ( heal? c>e pr(essionals1  
:i* may include                         

ob/etrician-gynecologi/s1 mat]nal-fetal 
m$ic9e speciali/s1 family physicians1   
prim>y c>e provid]s1 oral heal?         
provid]s1 physician assi/ants1 advanc$  
practice regi/]$ nurses su* z nurse     
practition]s & c]tifi$ nurse midwives1  
c]tifi$ midwives1 c]tifi$ pr(essional   
midwives1 social work]s1 traditional &  
community-bas$ d\las1 lactation         
consultants1 *ildbir? educators1        
community heal? work]s1 & o!r heal? c>e 
pr(essionals2  7,b7 conduct a risk      
assessm5t ( ea* su* eligible individual 
to det]m9e if h] pregnancy is high or l[
 risk1 & e/abli% a tailor$ pregnancy c>e
 plan1 :i* takes into consid]ation !    
individual's own pref]5ces & pregnancy  
c>e & bir?+ plans & det]m9es !          
appropriate support s]vices to r$uce !  
individual's m$ical1 social1 &          
environm5tal risk factors1 = ea* su*    
eligible individual bas$ on ! results ( 
su* risk assessm5t2  7,c7 assign ea* su*
 eligible individual to a c>e           
coord9ator1 :i* may be a nurse1 social  

work]1 traditional or community-bas$    
d\la1 community heal? work]1 midwife1 or
 o!r heal? c>e provid]1 :o is           
responsible = ensur+ t su* eligible     
individual receives ! necess>y m$ical   
c>e & connections to ess5tial support   
s]vices2  7,d7 provide1 or arrange = !  
provision (1 ess5tial support s]vices1  
su* z s]vices t address--  7i7 nutrition
 & ex]cise2  7ii7 smok+ cessation2      
7iii7 sub/ance use disord] & addiction  
treatm5t2  7iv7 anxiety1 depression1 &  
o!r m5tal & behavioral heal? issues2    
7v7 brea/ fe$+ initiation1 cont9uation1 
& duration2  7vi7 h\s+2  7vii7          
transportation2  7viii7 intimate p>tn]  
viol5ce2  7ix7 home visit+ s]vices2  7x7
 *ildbir? education2  7xi7 oral heal?   
education2  7xii7 cont9u\s labor        
support2 &  7xiii7 gr\p pr5atal c>e2    
7,e7 z appropriate1 facilitate          
connections to a usual prim>y c>e       
provid]1 :i* may be a wom5's heal?      
provid]2  7,f7 ref] to guidel9es &      
op9ions ( m$ical associations :5 det]m9+

 :e!r an elective deliv]y %\ld be p]=m$ 
on an eligible individual be=e #ci weeks
 ( ge/ation2  7,g7 provide su* eligible 
individuals ) evid5ce-bas$ education &  
res\rces to id5tify pot5tial w>n+ signs 
( pregnancy & po/p>tum complications &  
:5 & h[ to obta9 m$ical att5tion2  7,h7 
provide1 or arrange = ! provision (1    
pregnancy & po/p>tum heal? s]vices1     
includ+ family plann+ c\nsel+ & s]vices1
 to eligible individuals2  7,i7 track & 
report bir? outcomes ( su* eligible     
individuals & _! *ildr52  7,j7 ensure t 
c>e is pati5t-l$1 includ+ by engag+     
eligible individuals 9 _! own c>e1      
includ+ ?r\gh communication & education2
 &  7,k7 ensure adequate tra9+ =        
appropriately s]v+ ! population (       
individuals eligible = m$ical assi/ance 
"u ! ,/ate plan or waiv] ( su* plan1    
includ+ ?r\gh reproductive & bir? ju/ice
 frameworks1 race equity aw>5ess1 home  
visit+ skills1 & k ( social s]vices4    
7h7 ,t]m ( demon/ration project ,!      
,secret>y %all conduct ! demon/ration   

project = a p]iod ( #e ye>s4  7i7 ,waiv]
 au?ority ,to ! ext5t t ! ,secret>y     
det]m9es necess>y 9 ord] to c>ry out !  
demon/ration project1 ! ,secret>y may   
waive section #aijb7;a77#a7 7relat+ to  
/atewid5ess7 & section                  
#aijb7;a77#aj77;,b7 7relat+ to          
comp>ability74  7j7 ,te*nical assi/ance 
,! ,secret>y %all e/abli% a process to  
provide te*nical assi/ance to ,/ates t  
are aw>d$ grants "u ?is section & to    
eligible entities & o!r provid]s        
p>ticipat+ 9 a ,/ate mat]nity c>e home  
model fund$ by su* a grant4  7k7 ,report
  7#a7 ,9 g5]al ,n lat] ?an #ah mon?s   
aft] ! date ( ! enactm5t ( ?is section &
 annually !reaft] = ea* ye> ( !         
demon/ration project t]m1 ! ,secret>y   
%all submit a report to ,congress on !  
results ( ! demon/ration project4  7#b7 
,f9al report ,z "p ( ! f9al report      
requir$ "u p>agraph 7#a71 ! ,secret>y   
%all include-- 7,a7 ! results ( ! f9al  
report ( ! national ext]nal entity      
requir$ "u subsection 7f77#c77;,b77ii72 

&  7,b7 recomm5dations on :e!r ! model  
/udi$ 9 ! demon/ration project %\ld be  
cont9u$ or m widely adopt$1 includ+ by  
private heal? plans4  7l7 ,au?orization 
( appropriations ,!re are au?oriz$ to be
 appropriat$ to ! ,secret>y1 = ea* (    
fiscal ye>s #bjai ?r\gh #bjbf1 su* sums 
z may be necess>y to c>ry out ?is       
section4  4  #d4 ,reapplication (       
,m$ic>e paym5t rate floor to prim>y c>e 
s]vices furni%$ "u ,m$icaid & inclusion 
( additional provid]s  7a7              
,reapplication ( paym5t floor2          
additional provid]s  7#a7 ,9 g5]al      
,section #aijb7;a77#ac7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#ac77 is am5d$-- 7,a7 9      
subp>agraph 7,b71 by /rik+ 2 & & ins]t+ 
a semicolon2  7,b7 9 subp>agraph 7,c71  
by /rik+ ! semicolon & ins]t+ 2 &2 &    
7,c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,d7 paym5t = prim>y c>e  
s]vices 7z def9$ 9 subsection 7jj77#a77 
furni%$ 9 ! p]iod t beg9s on ! fir/ day 
( ! fir/ mon? t beg9s aft] ! date (     

enactm5t ( ! ,heal?y ,,mommies ,act by a
 provid] describ$ 9 subsection          
7jj77#b7--  7i7 at a rate t is n less   
?an #ajj p]c5t ( ! paym5t rate t applies
 to su* s]vices & ! provid] ( su*       
s]vices "u "p ,b ( title ,,xviii 7or1 if
 great]1 ! paym5t rate t w\ld be        
applicable "u su* "p if ! conv]sion     
factor "u section #ahdh7;d7 = ! ye> 7 ! 
conv]sion factor "u su* section =       
#bjji72  7ii7 9 ! case ( items & s]vices
 t are n items & s]vices provid$ "u su* 
"p1 at a rate to be e/abli%$ by !       
,secret>y2 &  7iii7 9 ! case ( items &  
s]vices t are furni%$ 9 rural areas 7z  
def9$ 9 section #ahhf7;d77#b77;,d771    
heal? pr(essional %ortage areas 7z def9$
 9 section #ccb7;a77#a77;,a7 ( ! ,public
 ,heal? ,s]vice ,act 7#db ,u4,s4,c4     
#bed;e7a77#a77;,a7771 or m$ically       
und]s]v$ areas 7accord+ to a designation
 "u section #ccj7;b77#c77;,a7 ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b7b77#c77;,a7771 at !    
rate o!rwise applicable to su* items or 

s]vices "u clause 7i7 or 7ii7 increas$1 
at ! ,secret>y's discretion1 by n m ?an 
#be p]c5t2  4  7#b7 ,con=m+ am5dm5ts    
7,a7 ,section #aijb7;a77#ac77;,c7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#ac77;,c77 is am5d$ by /rik+ 
subsection 7jj7 & ins]t+ subsection     
7jj77#a74  7,b7 ,section #aije7;dd7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7dd77 is am5d$-- 7i7 by /rik+    
,not)/&+ & ins]t+ ! foll[+3  7#a7 ,9    
g5]al ,not)/&+  2  7ii7 by /rik+ section
 #aijb7;a77#ac77;,c7 & ins]t+           
subp>agraph 7,c7 ( section              
#aijb7;a77#ac72  7iii7 by ins]t+ or =   
s]vices describ$ 9 subp>agraph 7,d7 (   
section #aijb7;a77#ac7 furni%$ dur+ an  
additional p]iod specifi$ 9 p>agraph    
7#b71 aft] #bjae12  7iv7 by /rik+ "u su*
 section & ins]t+ "u subp>agraph 7,c7 or
 7,d7 ( section #aijb7;a77#ac71 z       
applicable2 &  7v7 by add+ at ! end !   
foll[+3  7#b7 ,additional p]iods ,=     
purposes ( p>agraph 7#a71 ! foll[+ are  
additional p]iods3 7,a7 ,! p]iod t beg9s

 on ! fir/ day ( ! fir/ mon? t beg9s    
aft] ! date ( enactm5t ( ! ,heal?y      
,,mommies ,act4  4  7b7 ,improv$ t>get+ 
( prim>y c>e ,section #aijb7;jj7 ( !    
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7jj77 is am5d$-- 7#a7 by         
r$esignat+ p>agraphs 7#a7 & 7#b7 z      
clauses 7i7 & 7ii71 respectively &      
realign+ ! left m>g9s accord+ly2  7#b7  
by /rik+ ,= purposes ( subsection       
7a77#ac77;,c7 & ins]t+ ! foll[+3  7#a7  
,9 g5]al  7,a7 ,def9ition ,= purposes ( 
subp>agraphs 7,c7 & 7,d7 ( subsection   
7a77#ac7  2 &  7#c7 by ins]t+ aft]      
clause 7ii7 7z s r$esignat$7 ! foll[+3  
7,b7 ,exclusions ,su* t]m does n include
 any s]vices describ$ 9 subp>agraph 7,a7
 or 7,b7 ( p>agraph 7#a7 if su* s]vices 
are provid$ 9 an em]g5cy dep>tm5t ( a   
hospital4  7#b7 ,additional provid]s ,= 
purposes ( subp>agraph 7,d7 ( subsection
 7a77#ac71 a provid] describ$ 9 ?is     
p>agraph is any ( ! foll[+3  7,a7 ,a    
physician ) a prim>y specialty          
designation ( family m$ic9e1 g5]al      

int]nal m$ic9e1 or p$iatric m$ic9e1 or  
ob/etrics & gynecology4  7,b7 ,an       
advanc$ practice cl9ician1 z def9$ by ! 
,secret>y1 t works "u ! sup]vision (--  
7i7 a physician t satisfies ! crit]ia   
specifi$ 9 subp>agraph 7,a72  7ii7 a    
nurse practition] or a physician        
assi/ant 7z su* t]ms are def9$ 9 section
 #ahfa7;aa77#e77;,a77 :o is work+ 9     
accordance ) ,/ate law2 or  7iii7 or a  
c]tifi$ nurse-midwife 7z def9$ 9 section
 #ahfa7;gg77 :o is work+ 9 accordance ) 
,/ate law4  7,c7 ,a rural heal? cl9ic1  
f$]ally qualifi$ heal? c5t]1 or o!r     
heal? cl9ic t receives reimbursem5t on a
 fee s*$ule applicable to a physician4  
7,d7 ,an advanc$ practice cl9ician      
sup]vis$ by a physician describ$ 9      
subp>agraph 7,a71 ano!r advanc$ practice
 cl9ician1 or a c]tifi$ nurse-midwife4  
4  7c7 ,ensur+ paym5t by manag$ c>e     
entities  7#a7 ,9 g5]al ,section        
#aijc7m77#b77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;b7m77#b77;,a77
 is am5d$-- 7,a7 9 clause 7xii71 by     

/rik+ & aft] ! semicolon2  7,b7 by      
realign+ ! left m>g9 ( clause 7xiii7 s z
 to align ) ! left m>g9 ( clause 7xii7 &
 by /rik+ ! p]iod at ! end ( clause     
7xiii7 & ins]t+ 2 &2 &  7,c7 by ins]t+  
aft] clause 7xiii7 ! foll[+3  7xiv7 su* 
contract provides t 7,i7 paym5ts to     
provid]s specifi$ 9 section             
#aijb7;a77#ac77;,d7 = prim>y c>e s]vices
 def9$ 9 section #aijb7;jj7 t are       
furni%$ dur+ a ye> or p]iod specifi$ 9  
section #aijb7;a77#ac77;,d7 & section   
#aije7;dd7 are at lea/ equal to ! am\nts
 set =? & requir$ by ! ,secret>y by     
regulation1 7,,ii7 ! entity %all1 ^u    
reque/1 provide docum5tation to ! ,/ate1
 suffici5t to enable ! ,/ate & !        
,secret>y to ensure compliance )        
subclause 7,i71 & 7,,iii7 ! ,secret>y   
%all approve paym5ts describ$ 9         
subclause 7,i7 t are furni%$ ?r\gh an   
agre$ ^u capitation1 p>tial capitation1 
or o!r value-bas$ paym5t arrangem5t if !
 capitation1 p>tial capitation1 or o!r  
value-bas$ paym5t arrangem5t is bas$ on 

a reasonable me?odology & ! entity      
provides docum5tation to ! ,/ate        
suffici5t to enable ! ,/ate & !         
,secret>y to ensure compliance )        
subclause 7,i74  4  7#b7 ,con=m+ am5dm5t
 ,section #aicb7;f7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acifu-#b7;f77 is am5d$-- 7,a7 by /rik+ 
section #aijb7;a77#ac77;,c7 & ins]t+    
subsections 7,c7 & 7,d7 ( section       
#aijb7;a77#ac72 &  7,b7 by ins]t+ &     
clause 7xiv7 ( section #aijc7m77#b77;,a7
 be=e ! p]iod4  #e4 ,,macpac report &   
,,cms guidance on increas+ access to    
d\la c>e = ,m$icaid b5efici>ies  7a7    
,,macpac ,report  7#a7 ,9 g5]al ,n lat] 
?an #a ye> aft] ! date ( ! enactm5t (   
?is ,act1 ! ,m$icaid & ,,*ip ,paym5t &  
,access ,commission 7ref]r$ to 9 ?is    
section z ,,macpac7 %all publi% a report
 on ! cov]age ( d\la c>e "u ,/ate       
,m$icaid programs1 :i* %all at a m9imum 
include ! foll[+3  7,a7 ,in=mation ab\t 
cov]age = d\la c>e "u ,/ate ,m$icaid    
programs t curr5tly provide cov]age =   

su* c>e1 includ+ ! type ( d\la c>e (f]$ 
7su* z pr5atal1 labor & deliv]y1        
po/p>tum support1 & also community-bas$ 
& traditional d\la c>e74  7,b7 ,an      
analysis ( b>ri]s to cov]+ d\la c>e "u  
,/ate ,m$icaid programs4  7,c7 ,an      
id5tification ( effective /rategies to  
increase ! use ( d\la c>e 9 ord] to     
provide bett] c>e & a*ieve bett] mat]nal
 & infant heal? outcomes1 includ+       
/rategies t ,/ates may use to recruit1  
tra91 & c]tify a div]se d\la work=ce1   
p>ticul>ly f und]s]v$ communities1      
communities ( color1 & communities fac+ 
l+ui/ic or cultural b>ri]s4  7,d7       
,recomm5dations = legislative &         
adm9i/rative actions to increase access 
to d\la c>e 9 ,/ate ,m$icaid programs1  
includ+ actions t ensure d\las may e>n a
 liv+ wage t acc\nts = _! "t & co/s     
associat$ ) provid+ c>e4  7#b7          
,/akehold] consultation ,9 develop+ !   
report requir$ "u p>agraph 7#a71        
,,macpac %all consult ) relevant        
/akehold]s1 includ+--  7,a7 ,/ates2     

7,b7 organizations repres5t+ consum]s1  
includ+ ^? t are disproportionately     
impact$ by poor mat]nal heal? outcomes2 
7,c7 organizations & individuals        
repres5t+ d\la c>e provid]s1 includ+    
community-bas$ d\la programs & ^? :o    
s]ve und]s]v$ communities1 includ+      
communities ( color1 & communities fac+ 
l+ui/ic or cultural b>ri]s2 &  7,d7     
organizations repres5t+ heal? c>e       
provid]s4  7b7 ,,cms guidance  7#a7 ,9  
g5]al ,n lat] ?an #a ye> aft] ! date t  
,,macpac publi%es ! report requir$ "u   
subsection 7a77#a71 ! ,adm9i/rator ( !  
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices %all
 issue guidance to ,/ates on increas+   
access to d\la c>e "u ,m$icaid4 ,su*    
guidance %all at a m9imum include--     
7,a7 options = ,/ates to provide m$ical 
assi/ance = d\la c>e s]vices "u ,/ate   
,m$icaid programs2  7,b7 be/ practices =
 ensur+ t d\las1 includ+ community-bas$ 
d\las1 receive reimbursem5t = d\la c>e  
s]vices provid$ "u a ,/ate ,m$icaid     
program1 at a level t all[s d\las to e>n

 a liv+ wage t acc\nts = _! "t & co/s   
associat$ ) provid+ c>e2 &  7,c7 be/    
practices = increas+ access to d\la c>e 
s]vices1 includ+ s]vices provid$ by     
community-bas$ d\las1 "u ,/ate ,m$icaid 
programs4  7#b7 ,/akehold] consultation 
,9 develop+ ! guidance requir$ "u       
p>agraph 7#a71 ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e  ,m$icaid ,s]vices %all      
consult ) ,,macpac & o!r relevant       
/akehold]s1 includ+--  7,a7 ,/ate       
,m$icaid (ficials2  7,b7 organizations  
repres5t+ consum]s1 includ+ ^? t are    
disproportionately impact$ by poor      
mat]nal heal? outcomes2  7,c7           
organizations repres5t+ d\la c>e        
provid]s1 includ+ community-bas$ d\las &
 ^? :o s]ve und]s]v$ communities1 su* z 
communities ( color & communities fac+  
l+ui/ic or cultural b>ri]s2 &  7,d7     
organizations repres5t+ heal? c>e       
pr(essionals4  #f4 ,,gao report on ,/ate
 ,m$icaid programs' use ( telem$ic9e to 
increase access to mat]nity c>e ,n lat] 
?an #a ye> aft] ! date ( ! enactm5t (   

?is ,act1 ! ,comptroll] ,g5]al ( !      
,unit$ ,/ates %all submit a report to   
,congress on ,/ate ,m$icaid programs'   
use ( telem$ic9e to increase access to  
mat]nity c>e4 ,su* report %all include !
 foll[+3  7#a7 ,! numb] ( ,/ate ,m$icaid
 programs t utilize telem$ic9e to       
increase access to mat]nity c>e4  7#b7  
,) respect to ,/ate ,m$icaid programs t 
utilize telem$ic9e to increase access to
 mat]nity c>e1 in=mation ab\t--  7,a7   
common *>act]i/ics ( su* programs'      
approa*es to utiliz+ telem$ic9e to      
increase access to mat]nity c>e2 &  7,b7
 :at is kn[n ab\t-- 7i7 ! demographic   
*>act]i/ics ( ! individuals enroll$ 9   
su* programs :o use telem$ic9e to access
 mat]nity c>e2  7ii7 heal? outcomes =   
su* individuals z comp>$ to individuals 
) simil> *>act]i/ics :o did n use       
telem$ic9e to access mat]nity c>e2      
7iii7 ! s]vices provid$ to individuals  
?r\gh telem$ic9e1 includ+ family plann+ 
s]vices & oral heal? s]vices2  7iv7 !   
quality ( mat]nity c>e provid$ ?r\gh    

telem$ic9e1 includ+ :e!r mat]nity c>e   
provid$ ?r\gh telem$ic9e is culturally  
compet5t2  7v7 ! level ( pati5t         
satisfaction ) mat]nity c>e provid$     
?r\gh telem$ic9e to individuals enroll$ 
9 ,/ate ,m$icaid programs2 &  7vi7 !    
impact ( utiliz+ telem$ic9e to increase 
access to mat]nity c>e on sp5d+1 co/    
sav+s1 access to c>e1 & utilization (   
c>e "u ,/ate ,m$icaid programs4  7#c7   
,an id5tification & analysis ( ! b>ri]s 
to us+ telem$ic9e to increase access to 
mat]nity c>e "u ,/ate ,m$icaid programs4
  7#d7 ,recomm5dations = su* legislative
 & adm9i/rative actions relat$ to       
increas+ access to telem$ic9e mat]nity  
s]vices "u ,m$icaid z ! ,comptroll]     
,g5]al deems appropriate4