,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #hijg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,may #ai1 #bjbf,ms4   
,s*ak[sky 7= h]self1 ,ms4 ,b>ragn1 ,ms4 
,budz9ski1 ,mr4 ,c>bajal1 ,ms4 ,cl>ke ( 
,new ,york1 ,mr4 ,cleav]1 ,mr4 ,coh51   
,ms4 ,craig1 ,mr4 ,davis ( ,ill9ois1    
,ms4 ,dean ( ,p5nsylvania1 ,ms4         
,del,bene1 ,mr4 ,evans ( ,p5nsylvania1  
,mr4 ,g>am5di1 ,ms4 ,g>cia ( ,texas1    
,mr4 ,got!im]1 ,mrs4 ,hayes1 ,mr4       
,huffman1 ,mr4 ,kri%namoor?i1 ,mr4      
,lyn*1 ,ms4 ,mc,collum1 ,ms4            
,mc,clellan1 ,mr4 ,meeks1 ,ms4 ,m5g1    
,mr4 ,morelle1 ,ms4 ,moore ( ,wiscons91 
,mr4 ,m\lton1 ,mr4 ,mull91 ,ms4         
,pressley1 ,mr4 ,s*neid]1 ,ms4 ,sewell1 
,ms4 ,simon1 ,mr4 ,smi? ( ,wa%+ton1 ,ms4
 ,/rickl&1 ,ms4 ,/ansbury1 ,mrs4 ,sykes1
 ,mr4 ,takano1 ,ms4 ,tlaib1 ,mr4 ,tonko1
 ,mrs4 ,torres ( ,cali=nia1 ,mrs4       
,trahan1 ,mr4 ,v>gas1 ,mr4 ,veasey1 &   
,ms4 ,williams ( ,georgia7 introduc$ !  
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce  ,a     

,,bill  ,to direct ! ,adm9i/rator ( !   
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices to  
implem5t ! ,p]9atal ,c>e ,alt]native    
,paym5t ,model ,demon/ration ,project to
 te/ v>i\s paym5t models ) respect to   
mat]nity c>e provid$ to pregnant &      
po/p>tum individuals1 & = o!r purposes4 
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,innovative ,mat]nal ,paym5t &        
,cov]age ,to ,save ,moms ,act or !      
,,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 #bjbg ?r\gh      
#bjca1 ! ,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$icaid programs2  7#b7 mat]nity 
c>e provid]s & organizations repres5t+  
mat]nity c>e provid]s2  7#c7 relevant   
organizations repres5t+ pati5ts1 ) a    
p>ticul> focus on pati5ts f demographic 
gr\ps ) elevat$ rates ( mat]nal         
mortality1 sev]e mat]nal morbidity1     
mat]nal heal? disp>ities1 or o!r adv]se 
p]9atal or *ildbir? outcomes2  7#d7     
relevant community-bas$ organizations1  
p>ticul>ly organizations t seek to      
improve mat]nal heal? outcomes =        
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e

 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes2  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;d7l7771 ,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 demographic gr\ps ) elevat$
 rates ( mat]nal mortality1 sev]e       
mat]nal morbidity1 mat]nal heal?        
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? outcomes4  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 =        
individuals f demographic gr\ps )       
elevat$ rates ( mat]nal mortality1 sev]e
 mat]nal morbidity1 mat]nal heal?       
disp>ities1 or o!r adv]se p]9atal or    
*ildbir? 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 level1 includ+           
consid]ation ( ! appropriate transf] (  
pati5ts by pregnancy risk level2  7#c7  
e/abli%es evid5ce-bas$ quality metrics =
 su* paym5ts2  7#d7 includes            
consid]ation ( nonhospital bir? sett+s  
su* z free/&+ bir? c5t]s 7z s def9$72   
7#e7 includes consid]ation ( social     
det]m9ants ( mat]nal heal?2  7#f7       
includes div]se mat]nity c>e teams t    
include-- 7,a7 mat]nity c>e provid]s1   
m5tal & behavioral heal? c>e provid]s   
act+ 9 accordance ) ,/ate law1 & regi/]$
 dietitians or nutrition pr(essionals 7z

 su* t]m is def9$ 9 section             
#aciex7vv77#b7 ( title #db1 ,unit$      
,/ates ,code7--  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]s2 or  7#g7 includes         
consid]ation ( mat]nal m5tal heal?      
conditions & sub/ance use disord]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 prim>y      
language1 socioeconomic /atus1          
geography1 insurance type1 & 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 "o   
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> #bjca & exp&$ on a      
national basis4  7g7 ,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 ,mat]nal mortality ,! t]m mat]nal
 mortality means a dea? occurr+ dur+ or 
)9 a #a-ye> p]iod aft] pregnancy1 caus$ 

by pregnancy-relat$ or *ildbir?         
complications1 includ+ a suicide1       
ov]dose1 or o!r dea? result+ f a m5tal  
heal? or sub/ance use disord] attribut$ 
to or aggravat$ by pregnancy-relat$ or  
*ildbir? complications4  7#c7 ,mat]nity 
c>e provid] ,! t]m mat]nity c>e provid] 
means a heal? c>e provid] :o--  7,a7 is 
a physician1 a physician assi/ant1 a    
midwife :o meets1 at a m9imum1 !        
int]national def9ition ( a midwife &    
global /&>ds = midwif]y education z     
e/abli%$ by ! ,int]national ,conf$]ation
 ( ,midwives1 an advanc$ practice       
regi/]$ nurse1 a d\la accr$it$ by a     
,/ate to receive reimbursem5t = d\la    
s]vices "u a ,/ate plan 7or a waiv] (   
su* plan7 "u title ,,xix ( ! ,social    
,security ,act 7#db ,u4,s4,c4 #acif et  
seq471 or a lactation consultant c]tifi$
 by ! ,int]national ,bo>d ( ,lactation  
,consultant ,exam9]s2 &  7,b7 has a     
focus on mat]nal or p]9atal heal?4  7#d7
 ,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#e7 ,p]9atal  
heal? work] ,! t]m p]9atal heal? work]  
means a noncl9ical heal? work] focus$ on
 mat]nal or p]9atal heal?1 su* z a d\la1
 community heal? work]1 pe] support]1   
lactation educator or c\nselor1         
nutritioni/ or dietitian1 *ildbir?      
educator1 social work]1 home visitor1   
pati5t navigator or coord9ator1 or      
language int]pret]4  7#f7 ,po/p>tum &   
po/p>tum p]iod ,! t]ms po/p>tum &       
po/p>tum p]iod ref] to ! #a-ye> p]iod   
beg9n+ on ! la/ day ( ! pregnancy ( an  
individual4  7#g7 ,sev]e mat]nal        
morbidity ,! t]m sev]e mat]nal morbidity
 means a heal? condition1 includ+ m5tal 
heal? conditions & sub/ance use         
disord]s1 attribut$ to or aggravat$ by  
pregnancy or *ildbir? t results 9       
significant %ort-t]m or long-t]m        
consequ5ces to ! heal? ( ! individual :o
 0 pregnant4  7#h7 ,social det]m9ants ( 
mat]nal heal? ,! t]m social det]m9ants (

 mat]nal heal? means noncl9ical factors 
t impact mat]nal heal? outcomes4  7h7   
,au?orization ( appropriations ,!re are 
au?oriz$ to be appropriat$ su* sums z   
are necess>y to c>ry out ?is section4