,,ii #aafth ,,congress #b;d ,session ,s4 #cddc ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #aa1 #bjbj ,mr4 ,casey introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,xix of the ,social ,security ,act to provide ,medicaid coverage for all pregnant and postpartum women1 to provide coverage under the ,medicaid program for services provided by doulas1 midwives1 and lactation consultants1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,improving ,coverage and ,care for ,mothers ,act4 #b4 ,extending ,medicaid eligibility to all pregnant women 7a7 ,in general ,section #aije7n77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7n77#a77 is amended to read as follows3 7#a7 a woman who is pregnant and through the end of the month in which the #cfe-;day period 7beginning on the last day of her pregnancy7 ends2 and 4 7b7 ,conforming amendments ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended-- 7#a7 in section #aijb-- 7,a7 in subsection 7a77#aj77;,c7-- 7i7 in clause 7ii71 by striking must make available medical assistance-- and all that follows through individual described in subparagraph 7,a7 and inserting must make available medical assistance to individuals under the age of #ah who 7but for income and resources7 would be eligible for medical assistance as an individual described in subparagraph 7,a77i72 7ii7 in clause 7iii7-- 7,i7 by striking must include 7,i7 with respect to and inserting must include1 with respect to2 and 7,,ii7 by striking 2 and 7,,ii7 and all that follows through delivery services2 7,b7 in subsection 7e71 by striking paragraph 7#f72 7,c7 in subsection 7l77#a77;,a71 by inserting before ,january #a1 #bjbj1 before women during pregnancy2 and 7,d7 in subsection 7ii77#a77;,a71 by inserting that was in effect as of ,january #a1 #bjbj after pregnant women2 7#b7 in section #aibj7;b77#a77;,a71 by striking that the family income and all that follows through income level of eligibility and inserting that the woman is eligible for medical assistance2 and 7#c7 in section #aicg7;a77#b77;,b71 by amending clause 7i7 to read as follows3 7i7 ,qualified pregnant women ,the individual is a qualified pregnant woman 7as defined in section #aije7n77#a774 4 #c4 ,extending continuous ,medicaid and ,,chip coverage for pregnant and postpartum 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 #aijb7;e77#e71 by striking #fj-;day period and inserting #cfe-;day period2 7,b7 in section #aijb7l77#a77;,a71 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 7#c7 ,conforming amendment ,section #aich7;b77#b77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#h7;b77#b77;,c77 is amended by striking previous #fj days and inserting previous #cfe days4 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 7,a7 ,section #bajg7;e77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;gg7e77#a77 is amended-- 7i7 by redesignating subparagraphs 7,h7 through 7,s7 as subparagraphs 7,i7 through 7,t71 respectively2 and 7ii7 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 7,b7 ,section #baab of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7 is amended1 in subsections 7d77#b7 and 7f77#b71 by striking #fj-;day period each place it appears and inserting #cfe-;day period4 #d4 ,medicaid coverage of services provided by doulas1 midwives1 and lactation consultants 7a7 ,in general ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#bi71 by striking and at the end2 7,b7 by redesignating paragraph 7#cj7 as paragraph 7#ca72 and 7,c7 by inserting after paragraph 7#bi7 the following new paragraph3 7#cj7 services1 including-- 7,a7 prenatal1 delivery1 postpartum1 and lactation consulting services1 provided by doulas1 midwives1 and lactation consultants 7as those terms are defined in subsection 7gg77 to the extent authorized under ,state law2 and 7,b7 services included in the components of postpartum care identified by the ,american ,college of ,obstetricians and ,gynecologists in ,committee ,opinion ,number #gcf published in ,may of #bjah 7or any successor opinion or publication72 and 2 and 7#b7 by adding at the end the following new subsection3 7gg7 ,doulas and midwives defined ,for purposes of subsection 7a77#cj73 7#a7 ,doulas defined ,the term doula means an individual who-- 7,a7 is certified by an organization1 which has been established for not less than #e years and which requires the completion of continuing education to maintain such certification1 to provide non-medical advice1 information1 emotional support1 and physical comfort to an individual during such individual's pregnancy1 childbirth1 and postpartum period2 and 7,b7 maintains such certification by completing such required continuing education4 7#b7 ,midwives defined 7,a7 ,in general ,the term midwife means a certified midwife1 certified professional midwife1 and ,tribal-recognized midwife4 7,b7 ,certified midwife ,for purposes of subparagraph 7,a71 the term certified midwife means an individual who is certified by the ,american ,midwifery ,certification ,board to practice midwifery4 7,c7 ,certified professional midwife ,for purposes of subparagraph 7,a71 the term certified professional midwife means an individual who-- 7i7 is certified by the ,north ,american ,registry of ,midwives to practice midwifery for normal1 low-risk pregnancies and childbirths2 7ii7 completes-- 7,i7 a midwifery education program accredited by the ,midwifery ,education and ,accreditation ,council or any other entity recognized by the ,department of ,education2 or 7,,ii7 the requirements to obtain a ,midwifery ,bridge ,certificate from the ,north ,american ,registry of ,midwives2 and 7iii7 maintains the certification described in clause 7i7 by completing any required continuing education for such certification4 7,d7 ,tribal-recognized midwife ,for purposes of subparagraph 7,a71 the term ,tribal-recognized midwife means an individual who is recognized by an ,indian tribe 7as defined in section #d of the ,indian ,health ,care ,improvement ,act7 to practice midwifery for such tribe4 7#c7 ,lactation consultant defined ,the term lactation consultant means an individual who is a specialist who-- 7,a7 is trained to-- 7i7 focus on the needs and concerns of a breastfeeding mother and baby2 and 7ii7 prevent1 recognize1 and solve breastfeeding difficulties2 7,b7 is certified by an organization1 which has been established for not less than #e years and which requires the completion of continuing education to maintain such certification1 to provide lactation consulting services2 and 7,c7 maintains such certification by completing such required continuing education4 4 7b7 ,requiring mandatory coverage under ,state plan ,section #aijb7;a77#aj77;,a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77;,a77 is amended1 in the matter preceding clause 7i71 by striking and 7#bi7 and inserting 7#bi71 and 7#cj74 #e4 ,increased ,,fmap for additional expenditures ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d71 as amended by section #d1 is further amended-- 7#a7 in subsection 7b71 by striking and 7ff7 and inserting 7ff71 and 7hh72 and 7#b7 by adding at the end the following3 7hh7 ,increased ,,fmap for additional expenditures for medical assistance to pregnant and postpartum women ,for calendar quarters beginning on or after ,january #a1 #bjba1 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 ,improving ,coverage and ,care for ,mothers ,act 7as determined by the ,secretary71 shall be equal to #ajj percent4 4 #f4 ,effective date 7a7 ,in general ,subject to subsection 7b71 the amendments made by this ,act shall apply with respect to medical assistance furnished on or after ,january #a1 #bjba4 7b7 ,exception for ,state legislation ,in the case of a ,state plan under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 that the ,secretary of ,health and ,human ,services determines requires ,state legislation in order for the respective plan to meet any requirement imposed by amendments made by this section1 the respective plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet such an additional requirement before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that begins after the date of the enactment of this ,act4 ,for purposes of the previous sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session shall be considered to be a separate regular session of the ,state legislature4