,,ii #aafth ,,congress #ast ,session ,s4 #acdc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,may #g1 #bjai,mr4 ,booker 7for himself1 ,ms4 ,baldwin1 ,ms4 ,warren1 ,ms4 ,harris1 ,mrs4 ,gillibrand1 ,mr4 ,blumenthal1 and ,ms4 ,hirono7 introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend titles ,,xix and ,,xxi of the ,social ,security ,act to improve ,medicaid and the ,children's ,health ,insurance ,program for low-income mothers4 #a4 ,short title ,this ,act may be cited as the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act1 or the ,,mommies ,act4 #b4 ,enhancing ,medicaid and ,,chip benefits for low-income pregnant women 7a7 ,extending continuous ,medicaid and ,,chip coverage for pregnant and postpartum women 7#a7 ,medicaid ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended-- 7,a7 in section #aijb7l77#a77;,a71 by striking #fj-;day period and inserting #cfe-;day period2 7,b7 in section #aijb7;e77#f71 by striking #fj-;day period and inserting #cfe-;day period2 7,c7 in section #aijc7v77#d77;,a77i71 by striking #fj-;day period and inserting #cfe-;day period2 and 7,d7 in section #aije7;a71 in the #dth sentence in the matter following paragraph 7#cj71 by striking #fj-;day period and inserting #cfe-;day period4 7#b7 ,,chip ,section #baab of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7 is amended by striking #fj-;day period each place it appears and inserting #cfe-;day period4 7b7 ,requiring full benefits for pregnant and postpartum women 7#a7 ,medicaid 7,a7 ,in general ,paragraph 7#e7 of section #aijb7;e7 of the ,social ,security ,act 7#bd ,u4,s4,c4 #acif;a7e77 is amended to read as follows3 7#e7 ,any woman who is eligible for medical assistance under the ,state plan or a waiver of such plan and who is1 or who while so eligible becomes1 pregnant1 shall continue to be eligible under the plan or waiver for medical assistance through the end of the month in which the #cfe-;day period 7beginning on the last day of her pregnancy7 ends1 regardless of the basis for the woman's eligibility for medical assistance1 including if the woman's eligibility for medical assistance is on the basis of being pregnant4 4 7,b7 ,conforming amendment ,section #aijb7;a77#aj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is amended in the matter following subparagraph 7,g7 by striking 7,,vii7 the medical assistance and all that follows through complicate pregnancy14 7#b7 ,,chip ,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,h7 through 7,s7 as subparagraphs 7,i7 through 7,t71 respectively2 and 7,b7 by inserting after subparagraph 7,g71 the following3 7,h7 ,section #aijb7;e77#e7 7requiring #cfe-;day continuous coverage for pregnant and postpartum women74 4 7c7 ,requiring coverage of oral health services for pregnant and postpartum women 7#a7 ,medicaid ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7,a7 in subsection 7a77#d7-- 7i7 by striking 2 and 7,d7 and inserting 2 7,d72 and 7ii7 by inserting 2 and 7,e7 oral health services for pregnant and postpartum women 7as defined in subsection 7ff77 after subsection 7bb772 and 7,b7 by adding at the end the following new subsection3 7ff7 ,oral health services for pregnant and postpartum women 7#a7 ,in general ,for purposes of this title1 the term oral health services for pregnant and postpartum women means dental services necessary to prevent disease and promote oral health1 restore oral structures to health and function1 and treat emergency conditions that are furnished to a woman during pregnancy 7or during the #cfe-;day period beginning on the last day of the pregnancy74 7#b7 ,coverage requirements ,to satisfy the requirement to provide oral health services for pregnant and postpartum women1 a ,state shall1 at a minimum1 provide coverage for preventive1 diagnostic1 periodontal1 and restorative care consistent with recommendations for perinatal oral health care and dental care during pregnancy from the ,american ,academy of ,pediatric ,dentistry and the ,american ,college of ,obstetricians and ,gynecologists4 4 7#b7 ,,chip ,section #bajc7;c77#e77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77#e77;,a77 is amended by inserting or a targeted low-income pregnant woman after targeted low-income child4 7d7 ,maintenance of effort 7#a7 ,medicaid ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended-- 7,a7 in paragraph 7#gd71 by striking subsection 7gg72 and and inserting subsections 7gg7 and 7qq722 and 7,b7 by adding at the end the following new subsection3 7qq7 ,maintenance of effort related to low-,income pregnant women ,for calendar quarters beginning on or after the date of enactment of this subsection1 and before ,january #a1 #bjbc1 no ,federal payment shall be made to a ,state under section #aijc7;a7 for amounts expended under a ,state plan under this title or a waiver of such plan if the ,state-- 7#a7 has in effect under such plan eligibility standards1 methodologies1 or procedures 7including any enrollment cap or other numerical limitation on enrollment1 any waiting list1 any procedures designed to delay the consideration of applications for enrollment1 or similar limitation with respect to enrollment7 for individuals described in subsection 7l77#a7 who are eligible for medical assistance under the ,state plan or waiver under subsection 7a77#aj77;,a77ii77,,ix7 that are more restrictive than the eligibility standards1 methodologies1 or procedures1 respectively1 for such individuals under such plan or waiver that are in effect on the date of the enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act2 or 7#b7 provides medical assistance to individuals described in subsection 7l77#a7 who are eligible for medical assistance under such plan or waiver under subsection 7a77#aj77;,a77ii77,,ix7 at a level that is less than the level at which the ,state provides such assistance to such individuals under such plan or waiver on the date of the enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act4 4 7#b7 ,,chip ,section #baab of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll71 as amended by subsection 7b71 is further amended by adding at the end the following subsection3 7g7 ,maintenance of effort ,for calendar quarters beginning on or after ,january #a1 #bjbj1 and before ,january #a1 #bjbc1 no payment may be made under section #baje7;a7 with respect to a ,state child health plan if the ,state-- 7#a7 has in effect under such plan eligibility standards1 methodologies1 or procedures 7including any enrollment cap or other numerical limitation on enrollment1 any waiting list1 any procedures designed to delay the consideration of applications for enrollment1 or similar limitation with respect to enrollment7 for targeted low-income pregnant women that are more restrictive than the eligibility standards1 methodologies1 or procedures1 respectively1 under such plan that are in effect on the date of the enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act2 or 7#b7 provides pregnancy-related assistance to targeted low-income pregnant women under such plan at a level that is less than the level at which the ,state provides such assistance to such women under such plan on the date of the enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act4 4 7e7 ,enhanced ,,fmap ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d71 as amended by subsection 7c71 is further amended-- 7#a7 in subsection 7b71 by striking and 7aa7 and inserting 7aa71 and 7gg72 and 7#b7 by adding at the end the following3 7gg7 ,increased ,,fmap for additional expenditures for low-,income pregnant women ,for calendar quarters beginning on or after ,january #a1 #bjbj1 notwithstanding subsection 7b71 the ,federal medical assistance percentage for a ,state1 with respect to the additional amounts expended by such ,state for medical assistance under the ,state plan under this title or a waiver of such plan that are attributable to requirements imposed by the amendments made by the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act 7as determined by the ,secretary71 shall be equal to #ajj percent4 4 7f7 ,,gao study and report 7#a7 ,in general ,not later than #a year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit to ,congress a report on the gaps in coverage for-- 7,a7 pregnant women 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 the ,social ,security ,act 7#db ,u4,s4,c4 #acig;aa et seq472 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 7#b7 ,content of report ,the report required under this subsection shall include the following3 7,a7 ,information about the abilities and successes of ,state ,medicaid agencies in determining whether pregnant and postpartum women are eligible under another insurance affordability program1 and in transitioning any such women who are so eligible to coverage under such a program1 pursuant to section #dce4abjj of the title #db1 ,code of ,federal ,regulations 7as in effect on ,september #a1 #bjah74 7,b7 ,information on factors contributing to gaps in coverage 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;,a777 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,c7 ,recommendations for addressing and reducing such gaps in coverage4 7,d7 ,such other information as the ,comptroller ,general deems necessary4 7g7 ,effective date ,the amendments made by subsections 7a7 and 7b7 shall take effect ,january #a1 #bjbj4 #c4 ,maternity care home demonstration project ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended by inserting the following new section after section #aidf3 #aidg4 ,maternity care home demonstration project 7a7 ,in general ,not later than #a year after the date of the enactment of this section1 the ,secretary shall establish a demonstration project 7in this section referred to as the demonstration project7 under which the ,secretary shall provide grants to ,states to enter into arrangements with eligible entities to implement or expand a maternity care home model for eligible individuals4 7b7 ,definitions ,in this section3 7#a7 ,eligible entity ,the term eligible entity means an entity or organization that provides medically accurate1 comprehensive maternity services to individuals who are eligible for medical assistance under a ,state plan under this title or a waiver of such a plan1 and may include3 7,a7 ,a freestanding birth center4 7,b7 ,an entity or organization receiving assistance under section #ccj of the ,public ,health ,service ,act4 7,c7 ,a federally qualified health center4 7,d7 ,a rural health clinic4 7,e7 ,a health facility operated by an ,indian tribe or tribal organization 7as those terms are defined in section #d of the ,indian ,health ,care ,improvement ,act74 7#b7 ,eligible individual ,the term eligible individual means a pregnant woman or a formerly pregnant woman during the #cfe-;day period beginning on the last day of her pregnancy who is-- 7,a7 enrolled in a ,state plan under this title1 a waiver of such a plan1 or a ,state child health plan under title ,,xxi2 and 7,b7 a patient of an eligible entity which has entered into an arrangement with a ,state under subsection 7g74 7c7 ,goals of demonstration project ,the goals of the demonstration project are the following3 7#a7 ,to improve-- 7,a7 maternity and infant care outcomes2 7,b7 health equity2 7,c7 communication by maternity1 infant care1 and social services providers2 7,d7 integration of perinatal support services1 including community health workers1 doulas1 social workers1 public health nurses1 peer lactation counselors1 childbirth educators1 and others1 into health care entities and organizations2 7,e7 care coordination between maternity1 infant care1 oral health care1 and social services providers within the community2 7,f7 the quality and safety of maternity and infant care2 7,g7 the experience of women receiving maternity care1 including by increasing the ability of a woman to develop and follow her own birthing plan2 and 7,h7 access to adequate prenatal and postpartum care1 including-- 7i7 prenatal care that is initiated in a timely manner2 7ii7 not fewer than #b post-pregnancy visits to a maternity care provider2 and 7iii7 interpregnancy care4 7#b7 ,to provide coordinated1 evidence-based maternity care management4 7#c7 ,to decrease-- 7,a7 severe maternal morbidity and maternal mortality2 7,b7 overall health care spending2 7,c7 unnecessary emergency department visits2 7,d7 disparities in maternal and infant care outcomes1 including racial1 economic1 and geographical disparities2 7,e7 racial bias among health care professionals2 7,f7 the rate of cesarean deliveries for low-risk pregnancies2 7,g7 the rate of preterm births and infants born with low birth weight2 and 7,h7 the rate of avoidable maternal and newborn hospitalizations and admissions to intensive care units4 7d7 ,consultation ,in designing and implementing the demonstration project the ,secretary shall consult with stakeholders1 including-- 7#a7 ,states2 7#b7 organizations representing relevant health care professionals1 including oral health care professionals2 7#c7 organizations representing consumers1 including consumers that are disproportionately impacted by poor maternal health outcomes2 7#d7 representatives with experience implementing other maternity care home models1 including representatives from the ,center for ,medicare and ,medicaid ,innovation2 7#e7 community-based health care professionals1 including doulas1 and other stakeholders2 and 7#f7 experts in promoting health equity and combating racial bias in health care settings4 7e7 ,application and selection of ,states 7#a7 ,in general ,a ,state seeking to participate in the demonstration project shall submit an application to the ,secretary at such time and in such manner as the ,secretary shall require4 7#b7 ,selection of ,states 7,a7 ,in general ,the ,secretary may select #ae ,states to participate in the demonstration project4 7,b7 ,selection requirements ,in selecting ,states to participate in the demonstration project1 the ,secretary shall-- 7i7 ensure that there is geographic diversity in the areas in which activities will be carried out under the project2 and 7ii7 ensure that ,states with significant disparities in maternal and infant health outcomes1 including severe maternal morbidity1 and other disparities based on race1 income1 or access to maternity care1 are included4 7f7 ,grants 7#a7 ,in general ,from amounts appropriated under subsection 7l71 the ,secretary shall award #a grant for each year of the demonstration project to each ,state that is selected to participate in the demonstration project4 7#b7 ,use of grant funds ,a ,state may use funds received under this section to-- 7,a7 award grants or make payments to eligible entities as part of an arrangement described in subsection 7g77#b72 7,b7 provide financial incentives to health care professionals1 including community health workers and community-based doulas1 who participate in the ,state's maternity care home model2 7,c7 provide adequate training for health care professionals1 including community health workers1 doulas1 and care coordinators1 who participate in the ,state's maternity care home model1 which may include training for cultural competency1 racial bias1 health equity1 reproductive and birth justice1 home visiting skills1 and respectful communication and listening skills1 particularly in regards to maternal health2 7,d7 pay for personnel and administrative expenses associated with designing1 implementing1 and operating the ,state's maternity care home model2 7,e7 pay for items and services that are furnished under the ,state's maternity care home model and for which payment is otherwise unavailable under this title2 and 7,f7 pay for other costs related to the ,state's maternity care home model1 as determined by the ,secretary4 7#c7 ,grant for national independent evaluator 7,a7 ,in general ,from the amounts appropriated under subsection 7l71 prior to awarding any grants under paragraph 7#a71 the ,secretary shall enter into a contract with a national external entity to create a single1 uniform process to-- 7i7 ensure that ,states that receive grants under paragraph 7#a7 comply with the requirements of this section2 and 7ii7 evaluate the outcomes of the demonstration project in each participating ,state4 7,b7 ,annual report ,the contract described in subparagraph 7,a7 shall require the national external entity to submit to the ,secretary-- 7i7 a yearly evaluation report for each year of the demonstration project2 and 7ii7 a final impact report after the demonstration project has concluded4 7,c7 ,secretary's authority ,nothing in this paragraph shall prevent the ,secretary from making a determination that a ,state is not in compliance with the requirements of this section without the national external entity making such a determination4 7g7 ,partnership with eligible entities 7#a7 ,in general ,as a condition of receiving a grant under this section1 a ,state shall enter into an arrangement with one or more eligible entities that meets the requirements of paragraph 7#b74 7#b7 ,arrangements with eligible entities ,under an arrangement between a ,state and an eligible entity under this subsection1 the eligible entity shall perform the following functions1 with respect to eligible individuals enrolled with the entity under the ,state's maternity care home model-- 7,a7 provide culturally competent care1 which may include prenatal care1 family planning services1 medical care1 mental and behavioral care1 postpartum care1 and oral health care to such eligible individuals through a team of health care professionals1 which may include obstetrician-gynecologists1 maternal-fetal medicine specialists1 family physicians1 primary care providers1 oral health providers1 physician assistants1 advanced practice registered nurses such as nurse practitioners and certified nurse midwives1 certified midwives1 certified professional midwives1 social workers1 traditional and community-based doulas1 lactation consultants1 childbirth educators1 community health workers1 and other health care professionals2 7,b7 conduct a risk assessment of each such eligible individual to determine if her pregnancy is high or low risk1 and establish a tailored pregnancy care plan1 which takes into consideration the individual's own preferences and pregnancy care and birthing plans and determines the appropriate support services to reduce the individual's medical1 social1 and environmental risk factors1 for each such eligible individual based on the results of such risk assessment2 7,c7 assign each such eligible individual to a care coordinator1 which may be a nurse1 social worker1 traditional or community-based doula1 community health worker1 midwife1 or other health care provider1 who is responsible for ensuring that such eligible individual receives the necessary medical care and connections to essential support services2 7,d7 provide1 or arrange for the provision of1 essential support services1 such as services that address-- 7i7 nutrition and exercise2 7ii7 smoking cessation2 7iii7 substance use disorder and addiction treatment2 7iv7 anxiety1 depression1 and other mental and behavioral health issues2 7v7 breast feeding initiation1 continuation1 and duration2 7vi7 housing2 7vii7 transportation2 7viii7 intimate partner violence2 7ix7 home visiting services2 7x7 childbirth education2 7xi7 oral health education2 7xii7 continuous labor support2 and 7xiii7 group prenatal care2 7,e7 as appropriate1 facilitate connections to a usual primary care provider1 which may be a women's health provider2 7,f7 refer to guidelines and opinions of medical associations when determining whether an elective delivery should be performed on an eligible individual before #ci weeks of gestation2 7,g7 provide such eligible individuals with evidence-based education and resources to identify potential warning signs of pregnancy and postpartum complications and when and how to obtain medical attention2 7,h7 provide1 or arrange for the provision of1 pregnancy and postpartum health services1 including family planning counseling and services1 to eligible individuals2 7,i7 track and report birth outcomes of such eligible individuals and their children2 7,j7 ensure that care is patient-led1 including by engaging eligible individuals in their own care1 including through communication and education2 and 7,k7 ensure adequate training for appropriately serving the population of individuals eligible for medical assistance under the ,state plan or waiver of such plan1 including through reproductive and birth justice frameworks1 race equity awareness1 home visiting skills1 and knowledge of social services4 7h7 ,term of demonstration project ,the ,secretary shall conduct the demonstration project for a period of #e years4 7i7 ,waiver authority ,to the extent that the ,secretary determines necessary in order to carry out the demonstration project1 the ,secretary may waive section #aijb7;a77#a7 7relating to statewideness7 and section #aijb7;a77#aj77;,b7 7relating to comparability74 7j7 ,technical assistance ,the ,secretary shall establish a process to provide technical assistance to ,states that are awarded grants under this section and to eligible entities and other providers participating in a ,state maternity care home model funded by such a grant4 7k7 ,report 7#a7 ,in general ,not later than #ah months after the date of the enactment of this section and annually thereafter for each year of the demonstration project term1 the ,secretary shall submit a report to ,congress on the results of the demonstration project4 7#b7 ,final report ,as part of the final report required under paragraph 7#a71 the ,secretary shall include-- 7,a7 the results of the final report of the national external entity required under subsection 7f77#c77;,b77ii72 and 7,b7 recommendations on whether the model studied in the demonstration project should be continued or more widely adopted1 including by private health plans4 7l7 ,authorization of appropriations ,there are authorized to be appropriated to the ,secretary1 for each of fiscal years #bjai through #bjbf1 such sums as may be necessary to carry out this section4 4 #d4 ,reapplication of ,medicare payment rate floor to primary care services furnished under ,medicaid and inclusion of additional providers 7a7 ,reapplication of payment floor2 additional providers 7#a7 ,in general ,section #aijb7;a77#ac7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#ac77 is amended-- 7,a7 in subparagraph 7,b71 by striking 2 and and inserting a semicolon2 7,b7 in subparagraph 7,c71 by striking the semicolon and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,d7 payment for primary care services 7as defined in subsection 7jj77#a77 furnished in the period that begins on the first day of the first month that begins after the date of enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act by a provider described in subsection 7jj77#b7-- 7i7 at a rate that is not less than #ajj percent of the payment rate that applies to such services and the provider of such services under part ,b of title ,,xviii 7or1 if greater1 the payment rate that would be applicable under such part if the conversion factor under section #ahdh7;d7 for the year were the conversion factor under such section for #bjji72 7ii7 in the case of items and services that are not items and services provided under such part1 at a rate to be established by the ,secretary2 and 7iii7 in the case of items and services that are furnished in rural areas 7as defined in section #ahhf7;d77#b77;,d771 health professional shortage areas 7as defined in section #ccb7;a77#a77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;e7a77#a77;,a7771 or medically underserved areas 7according to a designation under section #ccj7;b77#c77;,a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b7b77#c77;,a7771 at the rate otherwise applicable to such items or services under clause 7i7 or 7ii7 increased1 at the ,secretary's discretion1 by not more than #be percent2 4 7#b7 ,conforming amendments 7,a7 ,section #aijb7;a77#ac77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#ac77;,c77 is amended by striking subsection 7jj7 and inserting subsection 7jj77#a74 7,b7 ,section #aije7;dd7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7dd77 is amended-- 7i7 by striking ,notwithstanding and inserting the following3 7#a7 ,in general ,notwithstanding 2 7ii7 by striking section #aijb7;a77#ac77;,c7 and inserting subparagraph 7,c7 of section #aijb7;a77#ac72 7iii7 by inserting or for services described in subparagraph 7,d7 of section #aijb7;a77#ac7 furnished during an additional period specified in paragraph 7#b71 after #bjae12 7iv7 by striking under such section and inserting under subparagraph 7,c7 or 7,d7 of section #aijb7;a77#ac71 as applicable2 and 7v7 by adding at the end the following3 7#b7 ,additional periods ,for purposes of paragraph 7#a71 the following are additional periods3 7,a7 ,the period that begins on the first day of the first month that begins after the date of enactment of the ,maximizing ,outcomes for ,moms through ,medicaid ,improvement and ,enhancement of ,services ,act4 4 7b7 ,improved targeting of primary care ,section #aijb7;jj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7jj77 is amended-- 7#a7 by redesignating paragraphs 7#a7 and 7#b7 as clauses 7i7 and 7ii71 respectively and realigning the left margins accordingly2 7#b7 by striking ,for purposes of subsection 7a77#ac77;,c7 and inserting the following3 7#a7 ,in general 7,a7 ,definition ,for purposes of subparagraphs 7,c7 and 7,d7 of subsection 7a77#ac7 2 and 7#c7 by inserting after clause 7ii7 7as so redesignated7 the following3 7,b7 ,exclusions ,such term does not include any services described in subparagraph 7,a7 or 7,b7 of paragraph 7#a7 if such services are provided in an emergency department of a hospital4 7#b7 ,additional providers ,for purposes of subparagraph 7,d7 of subsection 7a77#ac71 a provider described in this paragraph is any of the following3 7,a7 ,a physician with a primary specialty designation of family medicine1 general internal medicine1 or pediatric medicine1 or obstetrics and gynecology4 7,b7 ,an advanced practice clinician1 as defined by the ,secretary1 that works under the supervision of-- 7i7 a physician that satisfies the criteria specified in subparagraph 7,a72 7ii7 a nurse practitioner or a physician assistant 7as such terms are defined in section #ahfa7;aa77#e77;,a77 who is working in accordance with ,state law2 or 7iii7 or a certified nurse-midwife 7as defined in section #ahfa7;gg77 who is working in accordance with ,state law4 7,c7 ,a rural health clinic1 federally qualified health center1 or other health clinic that receives reimbursement on a fee schedule applicable to a physician4 7,d7 ,an advanced practice clinician supervised by a physician described in subparagraph 7,a71 another advanced practice clinician1 or a certified nurse-midwife4 4 7c7 ,ensuring payment by managed care entities 7#a7 ,in general ,section #aijc7m77#b77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7m77#b77;,a77 is amended-- 7,a7 in clause 7xii71 by striking and after the semicolon2 7,b7 by realigning the left margin of clause 7xiii7 so as to align with the left margin of clause 7xii7 and by striking the period at the end of clause 7xiii7 and inserting 2 and2 and 7,c7 by inserting after clause 7xiii7 the following3 7xiv7 such contract provides that 7,i7 payments to providers specified in section #aijb7;a77#ac77;,d7 for primary care services defined in section #aijb7;jj7 that are furnished during a year or period specified in section #aijb7;a77#ac77;,d7 and section #aije7;dd7 are at least equal to the amounts set forth and required by the ,secretary by regulation1 7,,ii7 the entity shall1 upon request1 provide documentation to the ,state1 sufficient to enable the ,state and the ,secretary to ensure compliance with subclause 7,i71 and 7,,iii7 the ,secretary shall approve payments described in subclause 7,i7 that are furnished through an agreed upon capitation1 partial capitation1 or other value-based payment arrangement if the capitation1 partial capitation1 or other value-based payment arrangement is based on a reasonable methodology and the entity provides documentation to the ,state sufficient to enable the ,state and the ,secretary to ensure compliance with subclause 7,i74 4 7#b7 ,conforming amendment ,section #aicb7;f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#b7;f77 is amended-- 7,a7 by striking section #aijb7;a77#ac77;,c7 and inserting subsections 7,c7 and 7,d7 of section #aijb7;a77#ac72 and 7,b7 by inserting and clause 7xiv7 of section #aijc7m77#b77;,a7 before the period4 #e4 ,,macpac report and ,,cms guidance on increasing access to doula care for ,medicaid beneficiaries 7a7 ,,macpac ,report 7#a7 ,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 care under ,state ,medicaid programs1 which shall at a minimum include the following3 7,a7 ,information about coverage for doula care under ,state ,medicaid programs that currently provide coverage for such care1 including the type of doula care offered 7such as prenatal1 labor and delivery1 postpartum support1 and also community-based and traditional doula care74 7,b7 ,an analysis of barriers to covering doula care under ,state ,medicaid programs4 7,c7 ,an identification of effective strategies to increase the use of doula care 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 care 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 7#b7 ,stakeholder consultation ,in developing the report required under paragraph 7#a71 ,,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 care 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 7b7 ,,cms guidance 7#a7 ,in general ,not later than #a year after the date that ,,macpac publishes the report required under subsection 7a77#a71 the ,administrator of the ,centers for ,medicare ,medicaid ,services shall issue guidance to ,states on increasing access to doula care under ,medicaid4 ,such guidance shall at a minimum include-- 7,a7 options for ,states to provide medical assistance for doula care services under ,state ,medicaid programs2 7,b7 best practices for ensuring that doulas1 including community-based doulas1 receive reimbursement for doula care services provided under a ,state ,medicaid program1 at a level that allows doulas to earn a living wage that accounts for their time and costs associated with providing care2 and 7,c7 best practices for increasing access to doula care services1 including services provided by community-based doulas1 under ,state ,medicaid programs4 7#b7 ,stakeholder consultation ,in developing the guidance required under paragraph 7#a71 the ,administrator of the ,centers for ,medicare ,medicaid ,services shall consult with ,,macpac and other relevant stakeholders1 including-- 7,a7 ,state ,medicaid officials2 7,b7 organizations representing consumers1 including those that are disproportionately impacted by poor maternal health outcomes2 7,c7 organizations representing doula care providers1 including community-based doulas and those who serve underserved communities1 such as communities of color and communities facing linguistic or cultural barriers2 and 7,d7 organizations representing health care professionals4 #f4 ,,gao report on ,state ,medicaid programs' use of telemedicine to increase access to maternity care ,not later than #a year after the date of the enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit a report to ,congress on ,state ,medicaid programs' use of telemedicine to increase access to maternity care4 ,such report shall include the following3 7#a7 ,the number of ,state ,medicaid programs that utilize telemedicine to increase access to maternity care4 7#b7 ,with respect to ,state ,medicaid programs that utilize telemedicine to increase access to maternity care1 information about-- 7,a7 common characteristics of such programs' approaches to utilizing telemedicine to increase access to maternity care2 and 7,b7 what is known about-- 7i7 the demographic characteristics of the individuals enrolled in such programs who use telemedicine to access maternity care2 7ii7 health outcomes for such individuals as compared to individuals with similar characteristics who did not use telemedicine to access maternity care2 7iii7 the services provided to individuals through telemedicine1 including family planning services and oral health services2 7iv7 the quality of maternity care provided through telemedicine1 including whether maternity care provided through telemedicine is culturally competent2 7v7 the level of patient satisfaction with maternity care provided through telemedicine to individuals enrolled in ,state ,medicaid programs2 and 7vi7 the impact of utilizing telemedicine to increase access to maternity care on spending1 cost savings1 access to care1 and utilization of care under ,state ,medicaid programs4 7#c7 ,an identification and analysis of the barriers to using telemedicine to increase access to maternity care under ,state ,medicaid programs4 7#d7 ,recommendations for such legislative and administrative actions related to increasing access to telemedicine maternity services under ,medicaid as the ,comptroller ,general deems appropriate4