,,ii  #aag? ,,congress  #a/ ,session    
,s4 #ccd  ,,9 ,,! ,,s5ate ,,( ,,!       
,,unit$ ,,/ates  ,febru>y #bb1 #bjba    
,mr4 ,casey 7= himself1 ,mr4 ,m55dez1 & 
,mr4 ,book]7 introduc$ ! foll[+ bill2   
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
e/abli% an alt]native paym5t model      
demon/ration project = mat]nity c>e     
provid$ to pregnant & po/p>tum          
individuals "u ,/ate ,m$icaid & ,,*ip   
programs1 & = o!r purposes4  #a4 ,%ort  
title ,?is ,act may be cit$ z ! ,,impact
 to ,save ,moms ,act4  #b4 ,p]9atal ,c>e
 ,alt]native ,paym5t ,model             
,demon/ration ,project  7a7 ,9 g5]al ,= 
! p]iod ( fiscal ye>s #bjbb ?r\gh #bjbf1
 ! ,secret>y ( ,heal? & ,human ,s]vices 
7ref]r$ to 9 ?is section z ! ,secret>y71
 act+ ?r\gh ! ,adm9i/rator ( ! ,c5t]s = 
,m$ic>e  ,m$icaid ,s]vices1 %all e/abli%
 & implem5t1 9 accordance ) !           
requirem5ts ( ?is section1 a            
demon/ration project1 to be kn[n z !    
,p]9atal ,c>e ,alt]native ,paym5t ,model

 ,demon/ration ,project 7ref]r$ to 9 ?is
 section z ! ,demon/ration ,project71 = 
purposes ( all[+ ,/ates to te/ paym5t   
models "u _! ,/ate plans "u title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq47 & ,/ate *ild   
heal? plans "u title ,,xxi ( su* ,act   
7#db ,u4,s4,c4 #acig;aa et seq47 )      
respect to mat]nity c>e provid$ to      
pregnant & po/p>tum individuals enroll$ 
9 su* ,/ate plans & ,/ate *ild heal?    
plans4  7b7 ,coord9ation ,9 e/abli%+ !  
,demon/ration ,project1 ! ,secret>y %all
 coord9ate ) /akehold]s su* z-- 7#a7    
,/ate ,m$icaid programs2  7#b7 mat]nity 
c>e provid]s & organizations repres5t+  
mat]nity c>e provid]s2  7#c7 relevant   
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f racial &    
e?nic m9ority gr\ps2  7#d7 relevant     
community-bas$ organizations1 p>ticul>ly
 organizations t seek to improve mat]nal
 heal? outcomes = pregnant & po/p>tum   
individuals f racial & e?nic m9ority    
gr\ps2  7#e7 p]9atal heal? work]s2  7#f7

 relevant heal? insurance issu]s2  7#g7 
hospitals1 heal? sy/ems1 midwif]y       
practices1 free/&+ bir? c5t]s 7z su* t]m
 is def9$ 9 p>agraph 7#c77;,b7 ( section
 #aije7l7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acif;d7l771 f$]ally     
qualifi$ heal? c5t]s 7z su* t]m is def9$
 9 p>agraph 7#b77;,b7 ( su* section71 & 
rural heal? cl9ics 7z su* t]m is def9$ 9
 section #ahfa7;aa7 ( su* ,act 7#db     
,u4,s4,c4 #aciex7aa7772  7#h7 rese>*]s &
 policy exp]ts 9 fields relat$ to       
mat]nity c>e paym5t models2 &  7#i7 any 
o!r /akehold]s z ! ,secret>y det]m9es   
appropriate1 ) a p>ticul> focus on      
/akehold]s f racial & e?nic m9ority     
gr\ps4  7c7 ,consid]ations ,9 e/abli%+ !
 ,demon/ration ,project1 ! ,secret>y    
%all consid] any alt]native paym5t model
 t-- 7#a7 is design$ to improve mat]nal 
heal? outcomes = racial & e?nic gr\ps ) 
disproportionate rates ( adv]se mat]nal 
heal? outcomes2  7#b7 includes me?ods = 
/ratify+ pati5ts by pregnancy risk level
 &1 z appropriate1 adju/+ paym5ts "u su*

 model to take into acc\nt pregnancy    
risk level2  7#c7 e/abli%es evid5ce-bas$
 quality metrics = su* paym5ts2  7#d7   
includes consid]ation ( non-hospital    
bir? sett+s su* z free/&+ bir? c5t]s 7z 
s def9$72  7#e7 includes consid]ation ( 
social det]m9ants ( mat]nal heal?2 or   
7#f7 includes div]se mat]nity c>e teams 
t include-- 7,a7 mat]nity c>e provid]s1 
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 regi/]$  
dietitians or nutrition pr(essionals 7z 
su* t]m is def9$ 9 section #ahfa7vv77#b7
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #aciex7vv77#b7771 &           
,int]national ,bo>d ,c]tifi$ ,lactation 
,consultants--  7i7 f racially1         
e?nically1 & pr(essionally div]se       
backgr\nds2  7ii7 ) exp]i5ce practic+ 9 
racially & e?nically div]se communities2
 or  7iii7 :o h und]gone tra9+ on       
implicit bias & racism2 &  7,b7 p]9atal 
heal? work]s4  7d7 ,eligibility ,to be  
eligible to p>ticipate 9 ! ,demon/ration
 ,project1 a ,/ate %all submit an       

application to ! ,secret>y at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require4  7e7 ,evaluation 
,! ,secret>y %all conduct an evaluation 
( ! ,demon/ration ,project to det]m9e ! 
impact ( ! ,demon/ration ,project on--  
7#a7 mat]nal heal? outcomes1 ) data     
/ratifi$ by race1 e?nicity1             
socioeconomic indicators1 & any o!r     
factors z ! ,secret>y det]m9es          
appropriate2  7#b7 sp5d+ on mat]nity c>e
 by ,/ates p>ticipat+ 9 ! ,demon/ration 
,project2  7#c7 to ! ext5t practicable1 
qualitative & quantitative measures (   
pati5t exp]i5ce2 &  7#d7 any o!r areas (
 assessm5t t ! ,secret>y det]m9es       
relevant4  7f7 ,report ,n lat] ?an #a   
ye> aft] ! completion or t]m9ation date 
( ! ,demon/ration ,project1 ! ,secret>y 
%all submit to ! ,congress1 & make      
publicly available1 a report conta9+--  
7#a7 ! results ( any evaluation conduct$
 "u subsection 7e72 &  7#b7 a           
recomm5dation reg>d+ :e!r !             
,demon/ration ,project %\ld be cont9u$  

aft] fiscal ye> #bjbf & exp&$ on a      
national basis4  7g7 ,au?orization (    
appropriations ,!re are au?oriz$ to be  
appropriat$ su* sums z are necess>y to  
c>ry out ?is section4  7h7 ,def9itions  
,9 ?is section3 7#a7 ,alt]native paym5t 
model ,! t]m alt]native paym5t model has
 ! mean+ giv5 su* t]m 9 section         
#ahcc7z77#c77;,c7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #aciel7z77#c77;,c774
  7#b7 ,p]9atal ,! t]m p]9atal means !  
p]iod beg9n+ on ! day an individual     
becomes pregnant & end+ on ! la/ day ( !
 #a-ye> p]iod beg9n+ on ! la/ day ( su* 
individual's pregnancy4  7#c7 ,racial & 
e?nic m9ority gr\p ,! t]m racial & e?nic
 m9ority gr\p has ! mean+ giv5 su* t]m 9
 section #agjg7;g77#a7 ( ! ,public      
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjju-#f7;g77#a774  #c4 ,,macpac report 
,n lat] ?an #b ye>s aft] ! date ( !     
enactm5t ( ?is ,act1 ! ,m$icaid & ,,*ip 
,paym5t & ,access ,commission %all      
publi% a report on issues relat+ to !   
cont9uity ( cov]age "u ,/ate plans "u   

title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 & ,/ate   
*ild heal? plans "u title ,,xxi ( su*   
,act 7#db ,u4,s4,c4 #acig;aa et seq47 = 
pregnant & po/p>tum individuals4 ,su*   
report %all1 at a m9imum1 include !     
foll[+3 7#a7 ,an assessm5t ( any exi/+  
policies "u su* ,/ate plans & su* ,/ate 
*ild heal? plans reg>d+ presumptive     
eligibility = pregnant individuals :ile 
_! application = enrollm5t 9 su* a ,/ate
 plan or su* a ,/ate *ild heal? plan is 
be+ process$4  7#b7 ,an assessm5t ( any 
exi/+ policies "u su* ,/ate plans & su* 
,/ate *ild heal? plans reg>d+ measures  
to ensure cont9uity ( cov]age "u su* a  
,/ate plan or su* a ,/ate *ild heal?    
plan = pregnant & po/p>tum individuals1 
includ+ su* individuals :o ne$ to *ange 
_! heal? insurance cov]age dur+ _!      
pregnancy or ! po/p>tum p]iod foll[+ _! 
pregnancy4  7#c7 ,an assessm5t ( any    
exi/+ policies "u su* ,/ate plans & su* 
,/ate *ild heal? plans reg>d+ measures  
to automatically re5roll individuals :o 

are eligible to enroll "u su* a ,/ate   
plan or su* a ,/ate *ild heal? plan z a 
p>5t4  7#d7 ,if det]m9$ appropriate by !
 ,commission1 any recomm5dations = !    
,dep>tm5t ( ,heal? & ,human ,s]vices1 or
 su* ,/ate plans & su* ,/ate *ild heal? 
plans1 to ensure cont9uity ( cov]age "u 
su* a ,/ate plan or su* a ,/ate *ild    
heal? plan = pregnant & po/p>tum        
individuals4