,i #aagth ,,congress #ast ,session ,h4 ,r4 #iej ,,in ,,the ,,house ,,of ,,representatives ,february #h1 #bjba,ms4 ,schakowsky 7for herself1 ,ms4 ,underwood1 ,ms4 ,adams1 ,mr4 ,khanna1 ,ms4 ,velzquez1 ,mrs4 ,mc,bath1 ,mr4 ,smith of ,washington1 ,ms4 ,scanlon1 ,mr4 ,lawson of ,florida1 ,mrs4 ,hayes1 ,mr4 ,butterfield1 ,ms4 ,moore of ,wisconsin1 ,ms4 ,strickland1 ,mr4 ,ryan1 ,mr4 ,schiff1 ,mr4 ,johnson of ,georgia1 ,mr4 ,horsford1 ,ms4 ,wasserman ,schultz1 ,ms4 ,barragn1 ,mr4 ,deutch1 ,mr4 ,payne1 ,mr4 ,blumenauer1 ,mr4 ,moulton1 ,mr4 ,soto1 ,mr4 ,nadler1 ,mr4 ,trone1 ,ms4 ,clarke of ,new ,york1 ,ms4 ,bass1 ,ms4 ,pressley1 ,mr4 ,evans1 ,ms4 ,blunt ,rochester1 ,ms4 ,castor of ,florida1 ,ms4 ,sewell1 and ,ms4 ,williams of ,georgia7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to require the ,secretary of ,health and ,human ,services to establish and implement a ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,innovative ,maternal ,payment ,and ,coverage ,to ,save ,moms ,act or the ,,impact to ,save ,moms ,act4 #b4 ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7a7 ,in general ,for the period of fiscal years #bjbb through #bjbf1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,administrator of the ,centers for ,medicare ,medicaid ,services1 shall establish and implement1 in accordance with the requirements of this section1 a demonstration project1 to be known as the ,perinatal ,care ,alternative ,payment ,model ,demonstration ,project 7referred to in this section as the ,demonstration ,project71 for purposes of allowing ,states to test payment models under their ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 with respect to maternity care provided to pregnant and postpartum individuals enrolled in such ,state plans and ,state child health plans4 7b7 ,coordination ,in establishing the ,demonstration ,project1 the ,secretary shall coordinate with stakeholders such as-- 7#a7 ,state ,medicaid programs2 7#b7 relevant organizations representing maternal health care providers2 7#c7 relevant organizations representing patients1 with a particular focus on individuals from demographic groups with disproportionate rates of adverse maternal health outcomes2 7#d7 relevant community-based organizations1 particularly organizations that seek to improve maternal health outcomes for individuals from demographic groups with disproportionate rates of adverse maternal health outcomes2 7#e7 non-clinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dieticians1 social workers1 home visitors1 and navigators2 7#f7 relevant health insurance issuers2 7#g7 hospitals1 health systems1 freestanding birth centers 7as such term is defined in paragraph 7#c77;,b7 of section #aije7l7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7l7771 ,federally-qualified health centers 7as such term is defined in paragraph 7#b77;,b7 of such section71 and rural health clinics 7as such term is defined in section #ahfa7;aa7 of such ,act 7#db ,u4,s4,c4 #aciex7aa7772 7#h7 researchers and policy experts in fields related to maternity care payment models2 and 7#i7 any other stakeholders as the ,secretary determines appropriate1 with a particular focus on stakeholders from demographic groups with disproportionate rates of adverse maternal health outcomes4 7c7 ,considerations ,in establishing the ,demonstration ,project1 the ,secretary shall consider each of the following3 7#a7 ,findings from any evaluations of the ,strong ,start for ,mothers and ,newborns initiative carried out by the ,centers for ,medicare ,medicaid ,services1 the ,health ,resources and ,services ,administration1 and the ,administration on ,children and ,families4 7#b7 ,any alternative payment model that-- 7,a7 is designed to improve maternal health outcomes for racial and ethnic groups with disproportionate rates of adverse maternal health outcomes2 7,b7 includes methods for stratifying patients by pregnancy risk level and1 as appropriate1 adjusting payments under such model to take into account pregnancy risk level2 7,c7 establishes evidence-based quality metrics for such payments2 7,d7 includes consideration of non-hospital birth settings such as freestanding birth centers 7as so defined72 7,e7 includes consideration of social determinants of health that are relevant to maternal health outcomes such as housing1 transportation1 nutrition1 and other non-clinical factors that influence maternal health outcomes2 or 7,f7 includes diverse maternity care teams that include-- 7i7 maternity care providers1 including obstetrician-gynecologists1 family physicians1 physician assistants1 midwives who meet1 at a minimum1 the international definition of the term midwife and global standards for midwifery education 7as established by the ,international ,confederation of ,midwives71 and nurse practitioners-- 7,i7 from racially1 ethnically1 and professionally diverse backgrounds2 7,,ii7 with experience practicing in racially and ethnically diverse communities2 or 7,,iii7 who have undergone trainings on racism1 implicit bias1 and explicit bias2 and 7ii7 non-clinical perinatal health workers such as doulas1 community health workers1 peer supporters1 certified lactation consultants1 nutritionists and dieticians1 social workers1 home visitors1 and navigators4 7d7 ,eligibility ,to be eligible to participate in the ,demonstration ,project1 a ,state shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may require4 7e7 ,evaluation ,the ,secretary shall conduct an evaluation of the ,demonstration ,project to determine the impact of the ,demonstration ,project on-- 7#a7 maternal health outcomes1 with data stratified by race1 ethnicity1 socioeconomic indicators1 and any other factors as the ,secretary determines appropriate2 7#b7 spending on maternity care by ,states participating in the ,demonstration ,project2 7#c7 to the extent practicable1 subjective measures of patient experience2 and 7#d7 any other areas of assessment that the ,secretary determines relevant4 7f7 ,report ,not later than one year after the completion or termination date of the ,demonstration ,project1 the ,secretary shall submit to the ,committee on ,energy and ,commerce1 the ,committee on ,ways and ,means1 and the ,committee on ,education and ,labor of the ,house of ,representatives and the ,committee on ,finance and the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate1 and make publicly available1 a report containing-- 7#a7 the results of any evaluation conducted under subsection 7e72 and 7#b7 a recommendation regarding whether the ,demonstration ,project should be continued after fiscal year #bjbf and expanded on a national basis4 7g7 ,authorization of appropriations ,there are authorized to be appropriated such sums as are necessary to carry out this section4 7h7 ,definitions ,in this section3 7#a7 ,alternative payment model ,the term alternative payment model has the meaning given such term in section #ahcc7z77#c77;,c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774 7#b7 ,perinatal ,the term perinatal means the period beginning on the day a woman becomes pregnant and ending on the last day of the #a-year period beginning on the last day of such woman's pregnancy4 #c4 ,,macpac report 7a7 ,in general ,not later than two years after the date of the enactment of this ,act1 the ,medicaid and ,,chip ,payment and ,access ,commission shall publish a report on issues relating to the continuity of coverage under ,state plans under title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 and ,state child health plans under title ,,xxi of such ,act 7#db ,u4,s4,c4 #acig;aa et seq47 for pregnant and postpartum individuals4 ,such report shall1 at a minimum1 include the following3 7#a7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding presumptive eligibility for pregnant individuals while their application for enrollment in such a ,state plan or such a ,state child health plan is being processed4 7#b7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum individuals1 including such individuals who need to change their health insurance coverage during their pregnancy or the postpartum period following their pregnancy4 7#c7 ,an assessment of any existing policies under such ,state plans and such ,state child health plans regarding measures to automatically reenroll individuals who are eligible to enroll under such a ,state plan or such a ,state child health plan as a parent4 7#d7 ,if determined appropriate by the ,commission1 any recommendations for the ,department of ,health and ,human ,services1 or such ,state plans and such ,state child health plans1 to ensure continuity of coverage under such a ,state plan or such a ,state child health plan for pregnant and postpartum women4 7b7 ,postpartum defined ,in this section1 the term postpartum means the #a-year period beginning on the last day of a woman's pregnancy4