,i  #aaith ,,congress  #ast ,session    
,h4 ,r4 #cbjb  ,,in ,,the ,,house ,,of  
,,representatives  ,may #e1 #bjbe,ms4   
,strickland 7for herself1 ,mr4          
,ciscomani1 ,ms4 ,randall1 and ,mrs4    
,kiggans of ,virginia7 introduced the   
following bill2 which was referred to   
the ,committee on ,armed ,services  ,a  
,,bill  ,to direct the ,secretary of    
,defense to carry out a pilot program to
 provide services from midwives to      
covered beneficiaries under the         
,,tricare program4  #a4 ,short title    
,this ,act may be cited as the ,maternal
 and ,infant ,delivery ,wellness and    
,integration with ,vital ,expertise     
,support for ,service ,members ,act of  
#bjbe or the ,,midwives for ,service    
,members ,act of #bjbe4  #b4 ,pilot     
program to make midwife services        
available through ,,tricare  7a7 ,pilot 
program ,not later than one year after  
the date of the enactment of this ,act1 
the ,secretary of ,defense shall begin a
 five-year pilot program to provide     

services from covered midwives to       
covered beneficiaries under the         
,,tricare program4  7b7 ,authority ,to  
make permanent ,if the ,secretary       
determines1 after the termination of the
 pilot program that such pilot program  
was successful1 the ,secretary may      
prescribe such regulations to establish 
a permanent program to make services    
from covered midwives available to      
covered beneficiaries as the ,secretary 
determines appropriate4  7c7 ,reports   
7#a7 ,implementation report ,not later  
than #ahj days after the date of the    
enactment of this ,act1 the ,secretary  
shall submit to the ,committees on      
,armed ,services of the ,house of       
,representatives and the ,senate a plan 
to implement the pilot program under    
subsection 7a74  7#b7 ,annual report    
,not later than one year after the date 
on which the pilot program begins and   
annually thereafter until the date that 
is #a year after the termination of the 
pilot program1 the ,secretary shall     

submit to the ,committees on ,armed     
,services of the ,house of              
,representatives and the ,senate a      
report including3 7,a7 ,the total cost  
of the pilot program and the cost per   
covered beneficiary who received care   
under the pilot program4  7,b7 ,the     
total number of covered beneficiaries   
who received care under the pilot       
program4  7,c7 ,the race1 ethnicity1    
age1 sex1 relationship status1 ,armed   
,force1 military occupation1 and rank1  
as applicable1 of covered beneficiaries 
who received care under the pilot       
program4  7,d7 ,an assessment of the    
effects of the pilot program on quality 
of care1 including-- 7i7 on maternal and
 fetal outcomes2 and  7ii7 on the number
 of preterm births1 low-weight births1  
and rates of caesarean section1 and such
 other data points as the ,secretary    
determines appropriate4  7,e7 ,an       
assessment of patient satisfaction of   
covered beneficiaries who received care 
through the pilot program4  7,f7 ,an    

assessment of access to maternity and   
labor and delivery care for covered     
beneficiaries1 including average wait   
time for an initial appointment and     
average travel time to the provider4    
7,g7 ,an assessment of the effectiveness
 of the pilot program4  7,h7            
,recommendations for adjustments to the 
pilot program4  7,i7 ,the estimated cost
 savings as a result of improved        
maternal and fetal health outcomes due  
to the pilot program4  7,j7 ,the        
,secretary of ,defense's recommendations
 relating to changes to the pilot       
program1 an extension of the pilot      
program1 and whether the pilot program  
should be expanded and made permanent4  
7d7 ,definitions ,in this section3 7#a7 
,the terms covered beneficiary and      
,,tricare program have the meanings     
given such terms in section #ajgb of    
title #aj1 ,united ,states ,code4  7#b7 
,the term covered midwife means a       
certified professional midwife or       
certified midwife who meets-- 7,a7 the  

international definition of a midwife1  
and global standards for midwifery      
education1 established by the           
,international ,confederation of        
,midwives1 and  7,b7 any professional   
credentialing requirement required to   
practice midwifery under applicable     
,state law4