#aafth ,,congress #b;d ,session ,h4 ,r4 #diif ,,an ,,act ,to amend title ,,xix of the ,social ,security ,act to provide for a ,state option under the ,medicaid program to provide for and extend continuous coverage for certain individuals1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,helping ,medicaid ,offer ,maternity ,services ,act of #bjbj or the ,helping ,,moms ,act of #bjbj4 #b4 ,modifications to certain coverage under ,medicaid and ,,chip for pregnant and postpartum women 7a7 ,state option ,section #aijb7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e77 is amended by adding at the end the following new paragraph3 7#af7 ,extending certain coverage for pregnant and postpartum women ,at the option of the ,state1 the ,state plan 7or waiver of such ,state plan7 may provide that an individual who1 while pregnant1 is eligible for and has received medical assistance under the ,state plan approved under this title 7or waiver of such plan7 7including during a period of retroactive eligibility under subsection 7a77#cd77 shall1 in addition to remaining eligible under paragraph 7#e7 for all pregnancy-related and postpartum medical assistance available under the ,state plan 7or wavier7 through the last day of the month in which the #fj-;day period 7beginning on the last day of her pregnancy7 ends1 remain eligible under the ,state plan 7or waiver7 for medical assistance and such medical assistance shall include all services covered under the ,state plan 7or waiver7 that is not less in amount1 duration1 or scope1 or is determined by the ,secretary to be substantially equivalent1 to the medical assistance available for an individual described in subsection 7a77#aj77;,a77i7 for the period beginning on the first day occurring after the end of such #fj-;day period and ending on the last day of the month in which the one-year period 7beginning on the last day of her pregnancy7 ends4 4 7b7 ,application to ,,chip 7#a7 ,in general ,section #bajg7;e77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is amended-- 7,a7 by redesignating subparagraphs 7,j7 through 7,s7 as subparagraphs 7,k7 through 7,t71 respectively2 and 7,b7 by inserting after subparagraph 7,i7 the following new subparagraph3 7,j7 ,in the case of a ,state that has elected to apply the option under section #aijb7;e77#af7 with respect to coverage for pregnant and postpartum women under title ,,xix1 the provisions of such section with respect to coverage of pregnant and postpartum women under this title1 except that such coverage shall be required and not at the option of the ,state4 4 7#b7 ,optional coverage of targeted low-income pregnant women ,section #baab7;d77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7d77#b77;,a77 is amended by inserting after #fj-;day period the following3 1 or1 in the case that section #aijb7;e77#af7 applies to the ,state child health plan 7or waiver of such plan7 pursuant to section #bajg7;e77#a71 the #a-year period4 7c7 ,effective date ,the amendments made by this section shall apply with respect to ,state elections made under paragraph 7#af7 of section #aijb7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7e771 as added by subsection 7a71 under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 on or after the first day of the first fiscal year quarter beginning at least one year after the date of the enactment of this ,act4 #c4 ,,macpac report 7a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission 7referred to in this section as ,,macpac7 shall publish a report on the coverage of doula services under ,state ,medicaid programs1 which shall at a minimum include the following3 7#a7 ,information about coverage for doula services under ,state ,medicaid programs that currently provide coverage for such services1 including the type of doula services offered 7such as prenatal1 labor and delivery1 postpartum support1 and also community-based and traditional doula services74 7#b7 ,an analysis of barriers to covering doula services under ,state ,medicaid programs4 7#c7 ,an identification of effective strategies to increase the use of doula services in order to provide better care and achieve better maternal and infant health outcomes1 including strategies that ,states may use to recruit1 train1 and certify a diverse doula workforce1 particularly from underserved communities1 communities of color1 and communities facing linguistic or cultural barriers4 7#d7 ,recommendations for legislative and administrative actions to increase access to doula services in ,state ,medicaid programs1 including actions that ensure doulas may earn a living wage that accounts for their time and costs associated with providing care4 7b7 ,stakeholder consultation ,in developing the report required under subsection 7a71 ,,macpac shall consult with relevant stakeholders1 including-- 7#a7 ,states2 7#b7 organizations representing consumers1 including those that are disproportionately impacted by poor maternal health outcomes2 7#c7 organizations and individuals representing doula services providers1 including community-based doula programs and those who serve underserved communities1 including communities of color1 and communities facing linguistic or cultural barriers2 and 7#d7 organizations representing health care providers4 #d4 ,,gao report 7a7 ,in general ,not later than #b years after the date of the enactment of this ,act and every five years thereafter1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on the ,state adoption1 under the ,medicaid program under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and the ,children's ,health ,insurance ,program under title ,,xxi of such ,act1 of extending coverage to #cfe days postpartum pursuant to the provisions of 7and amendments made by this ,act74 ,such report shall include the information and recommendations described in subsection 7b7 and shall also identify ongoing gaps in coverage for-- 7#a7 pregnant women under the ,medicaid program and the ,children's ,health ,insurance ,program2 and 7#b7 postpartum women under the ,medicaid program and the ,children's ,health ,insurance ,program who received assistance under either such program during their pregnancy4 7b7 ,content of report ,the report under subsection 7a7 shall include the following3 7#a7 ,information regarding the extent to which ,states have elected to extend coverage to #cfe days postpartum pursuant to the provisions of 7and amendments made by this ,act71 including which ,states make the election and when1 impacts on perinatal insurance churn in those ,states compared to ,states that did not make such election1 other health impacts of such election including regarding maternal mortality and morbidity rates1 and impacts on ,state and ,federal ,medicaid spending4 7#b7 ,information about the abilities1 successes1 and challenges of ,state ,medicaid agencies in-- 7,a7 transitioning their eligibility systems to incorporate such an election by a ,state and in determining whether pregnant and postpartum women are eligible under another insurance affordability program2 and 7,b7 transitioning any such women who are so eligible to coverage under such a program1 pursuant to section #aidc7;b77#c7 of the ,social ,security ,act 7#db ,u4,s4,c #acifw-#c7;b77#c774 7#c7 ,information on factors contributing to ongoing gaps in coverage resulting from women transitioning from coverage under the ,medicaid program or ,children's ,health ,insurance ,program that disproportionately impact underserved populations1 including low-income women1 women of color1 women who reside in a health professional shortage area 7as defined in section #ccb7;a77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#a77;,a7771 or who are members of a medically underserved population 7as defined by section #ccj7;b77#c7 of such ,act 7#db ,u4,s4,c4 #bed;b7b77#c77;,a7774 7#d7 ,recommendations for addressing and reducing such gaps in coverage4 7#e7 ,such other information as the ,comptroller ,general determines appropriate4 #e4 ,report on ,medicaid bundled payments for pregnancy-related services ,not later than #b years after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment ,advisory ,commission shall submit to ,congress a report containing an analysis of the use of bundled payments for reimbursing health care providers with respect to pregnancy-related services furnished under ,state plans 7or waivers of such plans7 under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq474 #f4 ,sunset of limit on maximum rebate amount for single source drugs and innovator multiple source drugs ,section #aibg7;c77#b77;,d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7;c77#b77;,d77 is amended by inserting after ,december #ca1 #bjji1 the following3 and before ,january #a1 #bjbc14 #g4 ,medicaid ,improvement ,fund ,section #aida7;b77#c7 of the ,social ,security ,act 7#db ,u4,s4,c #acifw-#a7;b77#c77 is amended-- 7#a7 in subparagraph 7,a71 by striking for fiscal year #bjbe and thereafter1 #a1ifj1jjj1jjj and inserting for fiscal year #bjbb and thereafter1 #i1bhf1jjj1jjj2 and 7#b7 in subparagraph 7,b71 by striking fiscal year #bjbe and inserting fiscal year #bjbb4 #h4 ,determination of budgetary effects ,the budgetary effects of this ,act1 for the purpose of complying with the ,statutory ,pay-,as-,you-,go ,act of #bjaj1 shall be determined by reference to the latest statement titled ,budgetary ,effects of ,,paygo ,legislation for this ,act1 submitted for printing in the ,congressional ,record by the ,chairman of the ,house ,budget ,committee1 provided that such statement has been submitted prior to the vote on passage4 ,passed the ,house of ,representatives ,september #bi1 #bjbj4;,clerk4