,,ii  #aai? ,,congress  #b;d ,session   
,s4 #diac  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #bd1 #bjbf,mr4   
,book] 7= himself1 ,mr4 ,blum5?al1 ,ms4 
,w>r51 ,ms4 ,duckwor?1 ,ms4 ,baldw91 &  
,ms4 ,smi?7 introduc$ ! foll[+ bill2 :i*
 0 read twice & ref]r$ to ! ,committee  
on ,f9ance  ,a ,,bill  ,to am5d titles  
,,xix & ,,xxi ( ! ,social ,security ,act
 to improve ,m$icaid & ! ,*ildr5's      
,heal? ,insurance ,program = l[-income  
mo!rs4  #a4 ,%ort title ,?is ,act may be
 cit$ z ! ,maximiz+ ,outcomes = ,moms   
?r\gh ,m$icaid ,improvem5t & ,enhancem5t
 ( ,s]vices ,act or ! ,,mommies ,act4   
#b4 ,enhanc+ ,m$icaid & ,,*ip b5efits = 
l[-income pregnant individuals  7a7     
,ext5d+ cont9u\s ,m$icaid & ,,*ip       
cov]age = pregnant & po/p>tum           
individuals  7#a7 ,m$icaid ,title ,,xix 
( ! ,social ,security ,act 7#db         
,u4,s4,c4 #acif et seq47 is am5d$-- 7,a7
 9 section #aijb7;e7-- 7i7 9 p>agraph   
7#f71 by /rik+ #fj-;day p]iod 7beg9n+ on
 ! la/ day ( h] pregnancy7 & ins]t+     

#a-ye> p]iod beg9n+ on ! la/ day ( !    
pregnancy 7or su* long] p]iod beg9n+ on 
su* day z ! ,/ate may elect72 &  7ii7 by
 /rik+ p>agraph 7#af72  7,b7 9 section  
#aijb7l77#a77;,a71 by /rik+ #fj-;day    
p]iod beg9n+ on ! la/ day ( ! pregnancy 
& ins]t+ #a-ye> p]iod beg9n+ on ! la/   
day ( ! pregnancy or su* long] p]iod    
beg9n+ on su* day z ! ,/ate may elect2  
7,c7 9 section #aijc7v77#d77;,a77i71 by 
/rik+ #fj-;day p]iod beg9n+ on ! la/ day
 ( ! pregnancy & ins]t+ #a-ye> p]iod    
beg9n+ on ! la/ day ( ! pregnancy or su*
 long] p]iod beg9n+ on su* day z ! ,/ate
 may elect2 &  7,d7 9 section #aije7;a71
 9 ! #d? s5t5ce 9 ! matt] foll[+ ! la/  
numb]$ p>agraph ( su* section1 by /rik+ 
#fj-;day p]iod beg9n+ on ! la/ day ( h] 
pregnancy & ins]t+ #a-ye> p]iod beg9n+  
on ! la/ day ( ! pregnancy1 or su* long]
 p]iod beg9n+ on su* day z ! ,/ate may  
elect4  7#b7 ,,*ip ,section #baab ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acigll7 is am5d$-- 7,a7 9 subsection   
7d77#b77;,a71 by /rik+ #fj-;day p]iod & 

all t foll[s ?r\gh ! semicolon & ins]t+ 
#a-ye> p]iod beg9n+ on ! la/ day ( !    
pregnancy1 or su* long] p]iod beg9n+ on 
su* day z ! ,/ate may elect1 ends22 &   
7,b7 9 subsection 7f77#b71 by /rik+     
#fj-;day p]iod 7beg9n+ on ! la/ day ( ! 
pregnancy7 & ins]t+ #a-ye> p]iod beg9n+ 
on ! la/ day ( ! pregnancy1 or su* long]
 p]iod beg9n+ on su* day z ! ,/ate may  
elect14  7b7 ,requir+ full b5efits =    
pregnant & po/p>tum individuals  7#a7 ,9
 g5]al ,p>agraph 7#e7 ( section         
#aijb7;e7 ( ! ,social ,security ,act    
7#bd ,u4,s4,c4 #acif;a7e77 is am5d$ to  
read z foll[s3  7#e7 ,cov]age ( full    
b5efits = at lea/ #a ye> = pregnant &   
po/p>tum individuals  7,a7 ,9 g5]al ,any
 individual :o1 :ile pregnant1 is       
eligible = & has receiv$ m$ical         
assi/ance "u ! ,/ate plan approv$ "u ?is
 title or a waiv] ( su* plan 7includ+   
dur+ a p]iod ( retroactive eligibility  
"u subsection 7a77#cd77 %all cont9ue to 
be eligible "u ! plan or waiv] = m$ical 
assi/ance ?r\gh ! end ( ! mon? 9 :i* !  

#a-ye> p]iod beg9n+ on ! la/ day ( !    
pregnancy1 or su* long] p]iod beg9n+ on 
su* day z ! ,/ate may elect1 ends1      
reg>dless ( ! basis = ! individual's    
eligibility = m$ical assi/ance1 includ+ 
if ! individual's eligibility = m$ical  
assi/ance is on ! basis ( be+ pregnant4 
7,b7 ,scope ( b5efits ,! m$ical         
assi/ance provid$ = a pregnant or       
po/p>tum individual describ$ 9          
subp>agraph 7,a7 %all-- 7i7 include all 
items & s]vices cov]$ "u ! ,/ate plan   
7or waiv]7 t are n less 9 am\nt1        
duration1 or scope1 or are det]m9$ by ! 
,secret>y to be sub/antially equival5t1 
to ! m$ical assi/ance available = an    
individual describ$ 9 subsection        
7a77#aj77;,a77i72 &  7ii7 be provid$ = !
 individual :ile pregnant & dur+ !      
#a-ye> p]iod t beg9s on ! la/ day ( !   
pregnancy1 or su* long] p]iod beg9n+ on 
su* day z ! ,/ate may elect1 & ends on !
 la/ day ( ! mon? 9 :i* su* p]iod ends4 
4  7#b7 ,con=m+ am5dm5ts  7,a7 ,section 
#aijb7;a77#aj7 ( ! ,social ,security    

,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is 
am5d$ 9 ! matt] foll[+ subp>agraph 7,g7 
by /rik+ 7,,vii7 ! m$ical assi/ance &   
all t foll[s ?r\gh dur+ ! p]iod describ$
 9 su* section14  7,b7 ,section         
#bajg7;e77#a77,k7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4                     
#acig;gg7e77#a77;,j77 is am5d$-- 7i7 by 
/rik+ ,p>agraphs 7#e7 & 7#af7 & ins]t+  
,p>agraph 7#e72 &  7ii7 by /rik+ 7relat+
 to & all t foll[s ?r\gh ! p]iod &      
ins]t+ 7relat+ to ! provision ( m$ical  
assi/ance to pregnant individuals dur+ &
 foll[+ pregnancy "u title ,,xix744  7c7
 ,requir+ cov]age ( oral heal? s]vices =
 pregnant & po/p>tum individuals  7#a7  
,m$icaid ,section #aije ( ! ,social     
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is am5d$-- 7,a7 9 subsection 7a77#d7--  
7i7 by /rik+ 2 & 7,d7 & ins]t+ 2 7,d72  
7ii7 by /rik+ 2 & 7,e7 & ins]t+ 2 7,e72 
7iii7 by /rik+ 2 & 7,f7 & ins]t+ 2 7,f72
 &  7iv7 by ins]t+ 2 & 7,g7 oral heal?  
s]vices = pregnant & po/p>tum           
individuals 7z def9$ 9 subsection 7ll77 

aft] 7or waiv] ( su* plan72 &  7,b7 by  
add+ at ! end ! foll[+ new subsection3  
7ll7 ,oral heal? s]vices = pregnant &   
po/p>tum individuals  7#a7 ,9 g5]al ,=  
purposes ( ?is title1 ! t]m oral heal?  
s]vices = pregnant & po/p>tum           
individuals means d5tal s]vices necess>y
 to prev5t disease & promote oral heal?1
 re/ore oral /ructures to heal? &       
function1 & treat em]g5cy conditions t  
are furni%$ to an individual dur+       
pregnancy 7or dur+ ! #a ye> p]iod t     
beg9s on ! la/ day ( ! pregnancy1 or su*
 long] p]iod beg9n+ on su* day z ! ,/ate
 may elect74  7#b7 ,cov]age requirem5ts 
,to satisfy ! requirem5t to provide oral
 heal? s]vices = pregnant & po/p>tum    
individuals1 a ,/ate %all1 at a m9imum1 
provide cov]age = prev5tive1 diagno/ic1 
p]iodontal1 & re/orative c>e consi/5t ) 
recomm5dations = compreh5sive p]9atal   
oral heal? s]vices & d5tal s]vices dur+ 
pregnancy f ! ,am]ican ,academy (       
,p$iatric ,d5ti/ry & ! ,am]ican ,college
 ( ,ob/etricians & ,gynecologi/s4  4    

7#b7 ,,*ip ,section #bajc7;c77#f77;,a7 (
 ! ,social ,security ,act 7#db ,u4,s4,c4
 #acig;cc7c77#f77;,a77 is am5d$ by      
ins]t+ or a t>get$ l[-income pregnant   
individual aft] t>get$ l[-income *ild4  
7#c7 ,te*nical am5dm5t ,section         
#baab7;d77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acigll7d77#b77 is      
am5d$-- 7,a7 9 ! p>agraph head]1 by     
ins]t+ 2 t>get$ l[-income pregnant      
individual aft] woman2 &  7,b7 by /rik+ 
! t]m t>get$ l[-income pregnant woman   
means & ins]t+ ! t]ms t>get$ l[-income  
pregnant woman & t>get$ l[-income       
pregnant individual mean4  7d7          
,ma9t5ance ( ef=t  7#a7 ,m$icaid        
,section #aijb ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;a7 is am5d$-- 
7,a7 9 subsection 7a77#gd71 by /rik+    
subsection 7gg72 & & ins]t+ subsections 
7gg7 & 7zz722 &  7,b7 by add+ at ! end !
 foll[+ new subsection3  7zz7 ,ma9t5ance
 ( ef=t relat$ to l[-,income pregnant   
individuals ,= cal5d> qu>t]s beg9n+ on  
or aft] ! date ( enactm5t ( ?is         

subsection1 & be=e ,janu>y #a1 #bjbg1 no
 ,f$]al paym5t %all be made to a ,/ate  
"u section #aijc7;a7 = am\nts exp5d$ "u 
a ,/ate plan "u ?is title or a waiv] (  
su* plan if ! ,/ate-- 7#a7 has 9 effect 
"u su* plan eligibility /&>ds1          
me?odologies1 or proc$ures 7includ+ any 
enrollm5t cap or o!r num]ical limitation
 on enrollm5t1 any wait+ li/1 any       
proc$ures design$ to delay !            
consid]ation ( applications = enrollm5t1
 any income c\nt+ rules1 or simil>      
limitation ) respect to enrollm5t7 =    
individuals describ$ 9 subsection       
7l77#a7 :o are eligible = m$ical        
assi/ance "u ! ,/ate plan or waiv] "u   
subsection 7a77#aj77;,a77ii77,,ix7 t are
 m re/rictive ?an ! eligibility /&>ds1  
me?odologies1 or proc$ures1             
respectively1 = su* individuals "u su*  
plan or waiv] t are 9 effect on ! date (
 ! enactm5t ( ! ,maximiz+ ,outcomes =   
,moms ?r\gh ,m$icaid ,improvem5t &      
,enhancem5t ( ,s]vices ,act2 or  7#b7   
r$uces ! am\nt1 duration1 or scope (    

m$ical assi/ance available to           
individuals describ$ 9 subsection       
7l77#a7 :o are eligible = m$ical        
assi/ance "u su* plan or waiv] "u       
subsection 7a77#aj77;,a77ii77,,ix7 f :at
 ! ,/ate provid$ to su* individuals "u  
su* plan or waiv] on ! date ( ! enactm5t
 ( ! ,maximiz+ ,outcomes = ,moms ?r\gh  
,m$icaid ,improvem5t & ,enhancem5t (    
,s]vices ,act4  4  7#b7 ,,*ip ,section  
#baab ( ! ,social ,security ,act 7#db   
,u4,s4,c4 #acigll71 z am5d$ by          
subsection 7a71 is fur!r am5d$ by add+  
at ! end ! foll[+ subsection3  7g7      
,ma9t5ance ( ef=t ,= cal5d> qu>t]s      
beg9n+ on or aft] ,janu>y #a1 #bjbg1 &  
be=e ,janu>y #a1 #bjca1 no paym5t may be
 made "u section #baje7;a7 ) respect to 
a ,/ate *ild heal? plan if ! ,/ate--    
7#a7 has 9 effect "u su* plan           
eligibility /&>ds1 me?odologies1 or     
proc$ures 7includ+ any enrollm5t cap or 
o!r num]ical limitation on enrollm5t1   
any wait+ li/1 any proc$ures design$ to 
delay ! consid]ation ( applications =   

enrollm5t1 or simil> limitation )       
respect to enrollm5t7 = t>get$ l[-income
 pregnant individuals t are m re/rictive
 ?an ! eligibility /&>ds1 me?odologies1 
or proc$ures1 respectively1 "u su* plan 
t are 9 effect on ! date ( ! enactm5t ( 
! ,maximiz+ ,outcomes = ,moms ?r\gh     
,m$icaid ,improvem5t & ,enhancem5t (    
,s]vices ,act2 or  7#b7 provides        
pregnancy-relat$ assi/ance to t>get$    
l[-income pregnant individuals "u su*   
plan at a level t is less ?an ! level at
 :i* ! ,/ate provides su* assi/ance to  
su* individuals "u su* plan on ! date ( 
! enactm5t ( ! ,maximiz+ ,outcomes =    
,moms ?r\gh ,m$icaid ,improvem5t &      
,enhancem5t ( ,s]vices ,act4  4  7e7    
,enhanc$ ,,fmap ,section #aije ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d71 z am5d$ by subsection 7c71 is 
fur!r am5d$-- 7#a7 9 subsection 7b71 by 
/rik+ & 7ii7 & ins]t+ 7ii71 & 7mm72 &   
7#b7 by add+ at ! end ! foll[+ new      
subsection3  7mm7 ,increas$ ,,fmap =    
additional exp5ditures = l[-,income     

pregnant individuals ,= cal5d> qu>t]s   
beg9n+ on or aft] ,janu>y #a1 #bjbg1    
not)/&+ subsection 7b71 ! ,f$]al m$ical 
assi/ance p]c5tage = a ,/ate1 ) respect 
to ! additional am\nts exp5d$ by su*    
,/ate = m$ical assi/ance "u ! ,/ate plan
 "u ?is title or a waiv] ( su* plan t   
are attributable to requirem5ts impos$  
by ! am5dm5ts made by ! ,maximiz+       
,outcomes = ,moms ?r\gh ,m$icaid        
,improvem5t & ,enhancem5t ( ,s]vices    
,act 7z det]m9$ by ! ,secret>y71 %all be
 equal to #ajj p]c5t4  4  7f7 ,,gao /udy
 & report  7#a7 ,9 g5]al ,n lat] ?an #a 
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates 
%all submit to ,congress a report on !  
gaps 9 cov]age =-- 7,a7 pregnant        
individuals "u ! ,m$icaid program "u    
title ,,xix ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acif et seq47 & !       
,*ildr5's ,heal? ,insurance ,program "u 
title ,,xxi ( ! ,social ,security ,act  
7#db ,u4,s4,c4 #acig;aa et seq472  7,b7 
po/p>tum individuals "u ! ,m$icaid      

program & ! ,*ildr5's ,heal? ,insurance 
,program :o receiv$ assi/ance "u ei!r   
su* program dur+ _! pregnancy2 &  7,c7  
bir?+ p betwe5 ! ages ( #ae & #di "u !  
,m$icaid program4  7#b7 ,cont5t ( report
 ,! report requir$ "u ?is subsection    
%all include ! foll[+3 7,a7 ,in=mation  
ab\t ! abilities & successes ( ,/ate    
,m$icaid ag5cies 9 det]m9+ :e!r pregnant
 & po/p>tum individuals are eligible "u 
ano!r insurance af=dability program1 & 9
 transition+ any su* individuals :o are 
s eligible to cov]age "u su* a program  
at ! end ( _! p]iod ( eligibility =     
m$ical assi/ance1 pursuant to section   
#dce4abjj ( ! title #db1 ,code ( ,f$]al 
,regulations 7z 9 effect on ,septemb]   
#a1 #bjah74  7,b7 ,in=mation on factors 
contribut+ to gaps 9 cov]age t          
disproportionately impact und]s]v$      
populations1 includ+ l[-income          
individuals1 ,black1 ,indig5\s1 & o!r   
individuals ( color1 individuals :o     
reside 9 a heal? pr(essional %ortage    
area 7z def9$ 9 section                 

#ccb7;a77#a77;,a7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bed;e7a77#a77;,a777 or individuals :o  
are memb]s ( a m$ically und]s]v$        
population 7z def9$ by section          
#ccj7;b77#c7 ( su* ,act 7#db ,u4,s4,c4  
#bed;b7b77#c77;,a7774  7,c7             
,recomm5dations = address+ & r$uc+ su*  
gaps 9 cov]age4  7,d7 ,su* o!r in=mation
 z ! ,comptroll] ,g5]al deems necess>y4 
7#c7 ,data disaggregation ,to ! greate/ 
ext5t possible1 ! ,comptroll] ,g5]al    
%all dissagregate data pres5t$ 9 !      
report1 includ+ by age1 g5d] id5tity1   
race1 e?nicity1 income level1 & o!r     
demographic factors4  7g7 ,effective    
date ,! am5dm5ts made by subsections 7a7
 & 7b7 %all take effect on ,janu>y #a1  
#bjbg4  #c4 ,mat]nity c>e home          
demon/ration project ,title ,,xix ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif et seq47 is am5d$ by ins]t+ !     
foll[+ new section aft] section #aidh3  
#aidi4 ,mat]nity ,c>e ,home             
,demon/ration ,project  7a7 ,9 g5]al ,n 

lat] ?an #a ye> aft] ! date ( ! enactm5t
 ( ?is section1 ! ,secret>y %all e/abli%
 a demon/ration project 79 ?is section  
ref]r$ to z ! demon/ration project7 "u  
:i* ! ,secret>y %all provide grants to  
,/ates to ent] into arrangem5ts )       
eligible entities to implem5t or exp& a 
mat]nity c>e home model = eligible      
individuals4  7b7 ,def9itions ,9 ?is    
section3 7#a7 ,eligible entity ,! t]m   
eligible entity means an entity or      
organization t provides m$ically        
accurate1 compreh5sive mat]nity s]vices 
to individuals :o are eligible = m$ical 
assi/ance "u a ,/ate plan "u ?is title  
or a waiv] ( su* a plan1 & may include3 
7,a7 ,a free/&+ bir? c5t]4  7,b7 ,an    
entity or organization receiv+ assi/ance
 "u section #ccj ( ! ,public ,heal?     
,s]vice ,act4  7,c7 ,a f$]ally qualifi$ 
heal? c5t]4  7,d7 ,a rural heal? cl9ic4 
7,e7 ,a heal? facility op]at$ by an     
,indian tribe or tribal organization 7z 
^? t]ms are def9$ 9 section #d ( !      
,indian ,heal? ,c>e ,improvem5t ,act74  

7#b7 ,eligible individual ,! t]m        
eligible individual means a pregnant    
individual or a =m]ly pregnant          
individual dur+ ! #a-ye> p]iod beg9n+ on
 ! la/ day ( ! pregnancy1 or su* long]  
p]iod beg9n+ on su* day z a ,/ate may   
elect1 :o is-- 7,a7 enroll$ 9 a ,/ate   
plan "u ?is title1 a waiv] ( su* a plan1
 or a ,/ate *ild heal? plan "u title    
,,xxi2 &  7,b7 a pati5t ( an eligible   
entity :i* has ent]$ into an arrangem5t 
) a ,/ate "u subsection 7g74  7c7 ,goals
 ( demon/ration project ,! goals ( !    
demon/ration project are ! foll[+3 7#a7 
,to improve-- 7,a7 mat]nity & infant c>e
 outcomes2  7,b7 bir? equity2  7,c7     
heal? equity =-- 7i7 ,black1 ,indig5\s1 
& o!r p ( color2  7ii7 lesbian1 gay1    
bisexual1 transg5d]1 que]1 non-b9>y1 &  
g5d] nonconfirm+ individuals2  7iii7 p  
:o live 9 regions ) limit$ or no access 
to ob/etric c>e2  7iv7 p ) disabilities2
 &  7v7 o!r und]s]v$ populations2  7,d7 
communication by & betwe5 mat]nity1     
infant c>e1 & social s]vices provid]s2  

7,e7 integration ( p]9atal support      
s]vices1 includ+ community heal? work]s1
 d\las1 social work]s1 public heal?     
nurses1 pe] lactation c\nselors1        
lactation consultants1 *ildbir?         
educators1 pe] m5tal heal? work]s1 &    
o!rs1 into heal? c>e entities &         
organizations2  7,f7 c>e coord9ation    
betwe5 mat]nity1 infant c>e1 oral heal? 
s]vices1 & social s]vices provid]s )9 ! 
community2  7,g7 ! quality & safety (   
mat]nity & infant c>e2  7,h7 ! exp]i5ce 
( individuals receiv+ respectful        
mat]nity c>e1 includ+ by increas+ !     
ability ( an individual to develop &    
foll[ _! own bir?+ plans2 &  7,i7 access
 to adequate pr5atal & po/p>tum c>e1    
includ+-- 7i7 pr5atal c>e t is initiat$ 
9 a timely mann]2  7ii7 n few] ?an #e   
po/-pregnancy visits to a mat]nity c>e  
provid] = po/p>tum c>e & support2  7iii7
 int]pregnancy c>e2 &  7iv7 support &   
treatm5t = p]9atal mood & anxiety       
disord]s4  7#b7 ,to provide coord9at$1  
evid5ce-bas$1 respectful1 culturally &  

l+ui/ically appropriate1 & p]son-c5t]$  
mat]nity c>e managem5t4  7#c7 ,to       
decrease-- 7,a7 prev5table & sev]e      
mat]nal morbidity & mat]nal mortality2  
7,b7 ov]all heal? c>e sp5d+2  7,c7      
unnecess>y em]g5cy dep>tm5t visits2     
7,d7 disp>ities 9 mat]nal & infant c>e  
outcomes1 includ+ racial1 economic1     
disability1 g5d]-bas$1 & geographical   
disp>ities2  7,e7 discrim9ation on !    
basis ( race1 color1 national orig91 sex
 7su* z g5d] id5tity1 sexual ori5tation1
 sex *>act]i/ics1 sex /]eotypes1        
pregnancy or relat$ conditions1 or      
m>ital /atus71 disability1 age1 income1 
or any comb9ation !re( among heal? c>e  
pr(essionals2  7,f7 discrim9ation on !  
basis ( race1 color1 national orig91 sex
 7su* z g5d] id5tity1 sexual ori5tation1
 sex *>act]i/ics1 sex /]eotypes1        
pregnancy or relat$ conditions1 or      
m>ital /atus71 disability1 age1 income1 
or any comb9ation !re(1 disrespect1     
trauma1 & abuse 9 mat]nity c>e sett+s2  
7,g7 ! rate ( ces>ean deliv]ies =       

l[-risk pregnancies2  7,h7 ! rate (     
pret]m bir?s & infants born ) l[ bir?   
weight2  7,i7 ! rate ( avoidable mat]nal
 & newborn hospitalizations & admissions
 to int5sive c>e units2 &  7,j7 ! rate (
 p]9atal mood & anxiety disord]s4  7d7  
,consultation ,9 design+ & implem5t+ !  
demon/ration project ! ,secret>y %all   
consult ) /akehold]s1 includ+-- 7#a7    
,/ates2  7#b7 organizations repres5t+   
relevant heal? c>e pr(essionals1 includ+
 oral heal? s]vices pr(essionals2  7#c7 
organizations1 p>ticul>ly reproductive  
ju/ice & bir? ju/ice organizations l$ by
 p ( color1 t repres5t consum]s (       
mat]nal heal? c>e1 includ+ consum]s (   
mat]nal heal? c>e :o are                
disproportionately impact$ by poor      
mat]nal heal? outcomes2  7#d7           
repres5tatives ) exp]i5ce implem5t+ o!r 
mat]nity c>e home models1 includ+       
repres5tatives f ! ,c5t] = ,m$ic>e &    
,m$icaid ,innovation2  7#e7             
community-bas$ heal? c>e pr(essionals1  
includ+ d\las1 lactation consultants1 & 

o!r /akehold]s2  7#f7 exp]ts 9 promot+  
heal? equity & combat+ racial bias 9    
heal? c>e sett+s2 &  7#g7 ,black1       
,indig5\s1 & o!r mat]nal heal? c>e      
consum]s ( color :o h exp]i5c$ sev]e    
mat]nal morbidity4  7e7 ,application &  
selection ( ,/ates  7#a7 ,9 g5]al ,a    
,/ate seek+ to p>ticipate 9 !           
demon/ration project %all submit an     
application to ! ,secret>y at su* "t & 9
 su* mann] z ! ,secret>y %all require4  
7#b7 ,selection ( ,/ates  7,a7 ,9 g5]al 
,! ,secret>y %all select at lea/ #aj    
,/ates to p>ticipate 9 ! demon/ration   
project4  7,b7 ,selection requirem5ts ,9
 select+ ,/ates to p>ticipate 9 !       
demon/ration project1 ! ,secret>y %all--
 7i7 ensure t !re is geographic &       
regional div]sity 9 ! areas 9 :i*       
activities w be c>ri$ out "u ! project2 
7ii7 ensure t ,/ates ) significant      
disp>ities 9 mat]nal & infant heal?     
outcomes1 includ+ sev]e mat]nal         
morbidity1 & o!r disp>ities bas$ on     
race1 income1 or access to mat]nity c>e1

 are includ$2 &  7iii7 ensure t at lea/ 
#a t]ritory is includ$4  7f7 ,grants    
7#a7 ,9 g5]al ,f am\nts appropriat$ "u  
subsection 7l71 ! ,secret>y %all aw>d #a
 grant = ea* ye> ( ! demon/ration       
project to ea* ,/ate t is select$ to    
p>ticipate 9 ! demon/ration project4    
7#b7 ,use ( grant funds ,a ,/ate may use
 funds receiv$ "u ?is section to-- 7,a7 
aw>d grants or make paym5ts to eligible 
entities z "p ( an arrangem5t describ$ 9
 subsection 7g77#b72  7,b7 provide      
f9ancial inc5tives to heal? c>e         
pr(essionals1 includ+ community-bas$    
heal? c>e work]s & community-bas$ d\las1
 :o p>ticipate 9 ! ,/ate's mat]nity c>e 
home model2  7,c7 provide adequate tra9+
 = heal? c>e pr(essionals1 includ+      
community-bas$ heal? c>e work]s1 d\las1 
& c>e coord9ators1 :o p>ticipate 9 !    
,/ate's mat]nity c>e home model1 :i* may
 include tra9+ = cultural humility &    
antiracism1 racial bias1 heal? equity1  
reproductive & bir? ju/ice1 trauma-in=m$
 c>e1 home visit+ skills1 & respectful  

communication & li/5+ skills1 p>ticul>ly
 9 reg>ds to mat]nal heal?2  7,d7 pay = 
p]sonnel & adm9i/rative exp5ses         
associat$ ) design+1 implem5t+1 & op]at+
 ! ,/ate's mat]nity c>e home model2     
7,e7 pay = items & s]vices t are furni%$
 "u ! ,/ate's mat]nity c>e home model & 
= :i* paym5t is o!rwise unavailable "u  
?is title2  7,f7 pay = s]vices &        
mat]ials to ensure culturally &         
l+ui/ically appropriate communication1  
includ+-- 7i7 language s]vices su* z    
int]pret]s & translation ( writt5       
mat]ials2 &  7ii7 developm5t (          
culturally & l+ui/ically appropriate    
mat]ials2 & auxili>y aids & s]vices2 &  
7,g7 pay = o!r co/s relat$ to ! ,/ate's 
mat]nity c>e home model1 z det]m9$ by ! 
,secret>y4  7#c7 ,grant = national      
indep5d5t evaluator  7,a7 ,9 g5]al ,f ! 
am\nts appropriat$ "u subsection 7l71   
prior to aw>d+ any grants "u p>agraph   
7#a71 ! ,secret>y %all ent] into a      
contract ) a national ext]nal entity to 
create a s+le1 uni=m process to-- 7i7   

ensure t ,/ates t receive grants "u     
p>agraph 7#a7 comply ) ! requirem5ts (  
?is section2 &  7ii7 evaluate ! outcomes
 ( ! demon/ration project 9 ea*         
p>ticipat+ ,/ate4  7,b7 ,annual report  
,! contract describ$ 9 subp>agraph 7,a7 
%all require ! national ext]nal entity  
to submit to ! ,secret>y-- 7i7 a ye>ly  
evaluation report = ea* ye> ( !         
demon/ration project2 &  7ii7 a f9al    
impact report aft] ! demon/ration       
project has conclud$4  7,c7 ,secret>y's 
au?ority ,no?+ 9 ?is p>agraph %all      
prev5t ! ,secret>y f mak+ a det]m9ation 
t a ,/ate is n 9 compliance ) !         
requirem5ts ( ?is section )\t ! national
 ext]nal entity mak+ su* a det]m9ation4 
7g7 ,p>tn]%ip ) eligible entities  7#a7 
,9 g5]al ,z a condition ( receiv+ a     
grant "u ?is section1 a ,/ate %all ent] 
into an arrangem5t ) "o or m eligible   
entities t meets ! requirem5ts (        
p>agraph 7#b74  7#b7 ,arrangem5ts )     
eligible entities ,"u an arrangem5t     
betwe5 a ,/ate & an eligible entity "u  

?is subsection1 ! eligible entity %all  
p]=m ! foll[+ functions1 ) respect to   
eligible individuals enroll$ ) ! entity 
"u ! ,/ate's mat]nity c>e home model3   
7,a7 ,provide culturally & l+ui/ically  
appropriate congru5t c>e1 :i* may       
include pr5atal c>e1 family plann+      
s]vices1 m$ical c>e1 m5tal & behavioral 
c>e1 po/p>tum c>e1 & oral heal? s]vices 
to su* eligible individuals ?r\gh a team
 ( heal? c>e pr(essionals1 :i* may      
include ob/etrician-gynecologi/s1       
mat]nal-fetal m$ic9e speciali/s1 family 
physicians1 prim>y c>e provid]s1 oral   
heal? provid]s1 physician assi/ants1    
advanc$ practice regi/]$ nurses su* z   
nurse practition]s & c]tifi$ nurse      
midwives1 c]tifi$ midwives1 c]tifi$     
pr(essional midwives1 physical !rapi/s1 
social work]s1 traditional &            
community-bas$ d\las1 lactation         
consultants1 *ildbir? educators1        
community heal? work]s1 pe] m5tal heal? 
support]s1 & o!r heal? c>e pr(essionals4
  7,b7 ,conduct a risk assessm5t ( ea*  

su* eligible individual to det]m9e if _!
 pregnancy is high or l[ risk1 & e/abli%
 a tailor$ pregnancy c>e plan1 :i* takes
 into consid]ation ! individual's own   
pref]5ces & pregnancy c>e & bir?+ plans 
& det]m9es ! appropriate support s]vices
 to r$uce ! individual's m$ical1 social1
 & environm5tal risk factors1 = ea* su* 
eligible individual bas$ on ! results ( 
su* risk assessm5t4  7,c7 ,assign ea*   
su* eligible individual to a culturally 
& l+ui/ically appropriate c>e           
coord9ator1 :i* may be a nurse1 social  
work]1 traditional or community-bas$    
d\la1 community heal? work]1 midwife1 or
 o!r heal? c>e provid]1 :o is           
responsible = ensur+ t su* eligible     
individual receives ! necess>y m$ical   
c>e & connections to ess5tial support   
s]vices4  7,d7 ,provide1 or arrange = ! 
provision (1 ess5tial support s]vices1  
su* z s]vices t address-- 7i7 food      
access1 nutrition1 & ex]cise2  7ii7     
smok+ cessation2  7iii7 sub/ance use    
disord] & addiction treatm5t2  7iv7     

anxiety1 depression1 trauma1 & o!r m5tal
 & behavioral heal? issues2  7v7 brea/  
fe$+1 *e/fe$+1 or o!r infant fe$+       
options supports1 initiation1           
cont9uation1 & duration2  7vi7 /able1   
af=dable1 safe1 & heal?y h\s+2  7vii7   
transportation2  7viii7 intimate p>tn]  
viol5ce2  7ix7 community & police       
viol5ce2  7x7 home visit+ s]vices2  7xi7
 *ildbir? & newborn c>e education2      
7xii7 oral heal? education2  7xiii7     
cont9u\s labor support2  7xiv7 gr\p     
pr5atal c>e2  7xv7 family plann+ &      
contraceptive c>e & supplies2 &  7xvi7  
af=dable *ild c>e4  7,e7 ,z appropriate1
 facilitate connections to a usual      
prim>y c>e provid]1 :i* may be a        
reproductive heal? c>e provid]4  7,f7   
,ref] to guidel9es & op9ions ( m$ical   
associations :5 det]m9+ :e!r an elective
 deliv]y %\ld be p]=m$ on an eligible   
individual be=e #ci weeks ( ge/ation4   
7,g7 ,provide su* eligible individual ) 
evid5ce-bas$ & culturally & l+ui/ically 
appropriate education & res\rces to     

id5tify pot5tial w>n+ signs ( pregnancy 
& po/p>tum complications & :5 & h[ to   
obta9 m$ical att5tion4  7,h7 ,provide1  
or arrange = ! provision (1 culturally &
 l+ui/ically appropriate pregnancy &    
po/p>tum heal? s]vices1 includ+ family  
plann+ c\nsel+ & s]vices1 to eligible   
individuals4  7,i7 ,track & report      
po/p>tum heal? & bir? outcomes ( su*    
eligible individuals & _! *ildr54  7,j7 
,ensure t c>e is p]son-c5t]$1 culturally
 & l+ui/ically appropriate1 & pati5t-l$1
 includ+ by engag+ eligible individuals 
9 _! own c>e1 includ+ ?r\gh             
communication & education4  7,k7 ,ensure
 adequate tra9+ = appropriately s]v+ !  
population ( individuals eligible =     
m$ical assi/ance "u ! ,/ate plan or     
waiv] ( su* plan1 includ+ ?r\gh         
reproductive ju/ice1 bir? ju/ice1 bir?  
equity1 & anti-raci/ frameworks1 home   
visit+ skills1 & k ( social s]vices4    
7h7 ,t]m ( demon/ration project ,!      
,secret>y %all conduct ! demon/ration   
project = a p]iod ( #e ye>s4  7i7 ,waiv]

 au?ority ,to ! ext5t t ! ,secret>y     
det]m9es necess>y 9 ord] to c>ry out !  
demon/ration project1 ! ,secret>y may   
waive section #aijb7;a77#a7 7relat+ to  
/atewid5ess7 & section                  
#aijb7;a77#aj77;,b7 7relat+ to          
comp>ability74  7j7 ,te*nical assi/ance 
,! ,secret>y %all e/abli% a process to  
provide te*nical assi/ance to ,/ates t  
are aw>d$ grants "u ?is section & to    
eligible entities & o!r provid]s        
p>ticipat+ 9 a ,/ate mat]nity c>e home  
model fund$ by su* a grant4  7k7 ,report
  7#a7 ,9 g5]al ,n lat] ?an #ah mon?s   
aft] ! date ( ! enactm5t ( ?is section &
 annually !reaft] = ea* ye> ( !         
demon/ration project t]m1 ! ,secret>y   
%all submit a report to ,congress on !  
results ( ! demon/ration project4  7#b7 
,f9al report ,z "p ( ! f9al report      
requir$ "u p>agraph 7#a71 ! ,secret>y   
%all include-- 7,a7 ! results ( ! f9al  
report ( ! national ext]nal entity      
requir$ "u subsection 7f77#c77;,b77ii72 
&  7,b7 recomm5dations on :e!r ! model  

/udi$ 9 ! demon/ration project %\ld be  
cont9u$ or m widely adopt$1 includ+ by  
private heal? plans4  7l7 ,au?orization 
( appropriations ,!re are au?oriz$ to be
 appropriat$ to ! ,secret>y1 = ea* (    
fiscal ye>s #bjbg ?r\gh #bjcd1 su* sums 
z may be necess>y to c>ry out ?is       
section4  4  #d4 ,reapplication (       
,m$ic>e paym5t rate floor to prim>y c>e 
s]vices furni%$ "u ,m$icaid & inclusion 
( additional provid]s  7a7              
,reapplication ( paym5t floor2          
additional provid]s  7#a7 ,9 g5]al      
,section #aijb7;a77#ac7 ( ! ,social     
,security ,act 7#db ,u4,s4,c4           
#acif;a7a77#ac77 is am5d$-- 7,a7 9      
subp>agraph 7,b71 by /rik+ 2 & & ins]t+ 
a semicolon2  7,b7 9 subp>agraph 7,c71  
by /rik+ ! semicolon & ins]t+ 2 &2 &    
7,c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,d7 paym5t = prim>y c>e  
s]vices 7z def9$ 9 subsection 7jj77#a77 
furni%$ 9 ! p]iod t beg9s on ! fir/ day 
( ! fir/ mon? t beg9s aft] ! date (     
enactm5t ( ! ,maximiz+ ,outcomes = ,moms

 ?r\gh ,m$icaid ,improvem5t &           
,enhancem5t ( ,s]vices ,act by a provid]
 describ$ 9 subsection 7jj77#b7-- 7i7 at
 a rate t is n less ?an #ajj p]c5t ( !  
paym5t rate t applies to su* s]vices & !
 provid] ( su* s]vices "u "p ,b ( title 
,,xviii 7or1 if great]1 ! paym5t rate t 
w\ld be applicable "u su* "p if !       
conv]sion factor "u section #ahdh7;d7 = 
! ye> 7 ! conv]sion factor "u su*       
section = #bjji72  7ii7 9 ! case ( items
 & s]vices t are n items & s]vices      
provid$ "u su* "p1 at a rate to be      
e/abli%$ by ! ,secret>y2 &  7iii7 9 !   
case ( items & s]vices t are furni%$ 9  
rural areas 7z def9$ 9 section          
#ahhf7;d77#b77;,d771 heal? pr(essional  
%ortage areas 7z def9$ 9 section        
#ccb7;a77#a77;,a7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#bed;e7a77#a77;,a7771 or m$ically       
und]s]v$ areas 7accord+ to a designation
 "u section #ccj7;b77#c77;,a7 ( !       
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bed;b7b77#c77;,a7771 at !    

rate o!rwise applicable to su* items or 
s]vices "u clause 7i7 or 7ii7 increas$1 
at ! ,secret>y's discretion1 by n m ?an 
#be p]c5t2  4  7#b7 ,con=m+ am5dm5ts    
7,a7 ,section #aijb7;a77#ac77;,c7 ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#ac77;,c77 is am5d$ by /rik+ 
subsection 7jj7 & ins]t+ subsection     
7jj77#a74  7,b7 ,section #aije7;dd7 ( ! 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7dd77 is am5d$-- 7i7 by /rik+    
,not)/&+ & ins]t+ ! foll[+3  7#a7 ,9    
g5]al ,not)/&+  2  7ii7 9 p>agraph 7#a71
 z add$ by clause 7i7-- 7,i7 by /rik+   
section #aijb7;a77#ac77;,c7 & ins]t+    
subp>agraph 7,c7 ( section              
#aijb7;a77#ac72  7,,ii7 by ins]t+ or =  
s]vices describ$ 9 subp>agraph 7,d7 (   
section #aijb7;a77#ac7 furni%$ dur+ an  
additional p]iod specifi$ 9 p>agraph    
7#b71 aft] #bjae12 &  7,,iii7 by /rik+  
"u su* section & ins]t+ "u subp>agraph  
7,c7 or 7,d7 ( section #aijb7;a77#ac71 z
 applicable2 &  7iii7 by add+ at ! end !
 foll[+3  7#b7 ,additional p]iod ,=     

purposes ( p>agraph 7#a71 ! additional  
p]iod %all be ! p]iod t beg9s on ! fir/ 
day ( ! fir/ mon? t beg9s aft] ! date ( 
enactm5t ( ! ,maximiz+ ,outcomes = ,moms
 ?r\gh ,m$icaid ,improvem5t &           
,enhancem5t ( ,s]vices ,act4  4  7b7    
,improv$ t>get+ ( prim>y c>e ,section   
#aijb7;jj7 ( ! ,social ,security ,act   
7#db ,u4,s4,c4 #acif;a7jj77 is am5d$--  
7#a7 by r$esignat+ p>agraphs 7#a7 & 7#b7
 z clauses 7i7 & 7ii71 respectively &   
realign+ ! left m>g9s accord+ly2  7#b7  
by /rik+ ,= purposes ( subsection       
7a77#ac77;,c7 & ins]t+ ! foll[+3  7#a7  
,9 g5]al  7,a7 ,def9ition ,= purposes ( 
subp>agraphs 7,c7 & 7,d7 ( subsection   
7a77#ac7  2 &  7#c7 by ins]t+ aft]      
clause 7ii7 7z s r$esignat$7 ! foll[+3  
7,b7 ,exclusions ,su* t]m does n include
 any s]vices describ$ 9 subp>agraph 7,a7
 or 7,b7 ( p>agraph 7#a7 if su* s]vices 
are provid$ 9 an em]g5cy dep>tm5t ( a   
hospital4  7#b7 ,additional provid]s ,= 
purposes ( subp>agraph 7,d7 ( subsection
 7a77#ac71 a provid] describ$ 9 ?is     

p>agraph is any ( ! foll[+3 7,a7 ,a     
physician ) a prim>y specialty          
designation ( family m$ic9e1 g5]al      
int]nal m$ic9e1 or p$iatric m$ic9e1 or  
ob/etrics & gynecology4  7,b7 ,an       
advanc$ practice cl9ician1 z def9$ by ! 
,secret>y1 t works "u ! sup]vision (--  
7i7 a physician t satisfies ! crit]ia   
specifi$ 9 subp>agraph 7,a72  7ii7 a    
nurse practition] or a physician        
assi/ant 7z su* t]ms are def9$ 9 section
 #ahfa7;aa77#e77;,a77 :o is work+ 9     
accordance ) ,/ate law2 or  7iii7 a     
c]tifi$ nurse-midwife 7z def9$ 9 section
 #ahfa7;gg77 or a c]tifi$ pr(essional   
midwife :o is work+ 9 accordance ) ,/ate
 law4  7,c7 ,a rural heal? cl9ic1       
f$]ally qualifi$ heal? c5t]1 heal? c5t] 
t receives fund+ "u title ,x ( ! ,public
 ,heal? ,s]vice ,act1 or o!r heal? cl9ic
 t receives reimbursem5t on a fee s*$ule
 applicable to a physician4  7,d7 ,an   
advanc$ practice cl9ician sup]vis$ by a 
physician describ$ 9 subp>agraph 7,a71  
ano!r advanc$ practice cl9ician1 or a   

c]tifi$ nurse-midwife4  7,e7 ,a midwife 
:o is work+ 9 accordance ) ,/ate law4  4
  7c7 ,ensur+ paym5t by manag$ c>e      
entities  7#a7 ,9 g5]al ,section        
#aijc7m77#b77;,a7 ( ! ,social ,security 
,act 7#db ,u4,s4,c4 #acif;b7m77#b77;,a77
 is am5d$-- 7,a7 9 clause 7xii71 by     
/rik+ & aft] ! semicolon2  7,b7 by      
realign+ ! left m>g9 ( clause 7xiii7 s z
 to align ) ! left m>g9 ( clause 7xii7 &
 by /rik+ ! p]iod at ! end ( clause     
7xiii7 & ins]t+ 2 &2 &  7,c7 by ins]t+  
aft] clause 7xiii7 ! foll[+3  7xiv7 su* 
contract provides t 7,i7 paym5ts to     
provid]s specifi$ 9 section             
#aijb7;a77#ac77;,d7 = prim>y c>e s]vices
 def9$ 9 section #aijb7;jj7 t are       
furni%$ dur+ a ye> or p]iod specifi$ 9  
section #aijb7;a77#ac77;,d7 & section   
#aije7;dd7 are at lea/ equal to ! am\nts
 set =? & requir$ by ! ,secret>y by     
regulation1 7,,ii7 ! entity %all1 ^u    
reque/1 provide docum5tation to ! ,/ate1
 suffici5t to enable ! ,/ate & !        
,secret>y to ensure compliance )        

subclause 7,i71 & 7,,iii7 ! ,secret>y   
%all approve paym5ts describ$ 9         
subclause 7,i7 t are furni%$ ?r\gh an   
agre$ ^u capitation1 p>tial capitation1 
or o!r value-bas$ paym5t arrangem5t if !
 capitation1 p>tial capitation1 or o!r  
value-bas$ paym5t arrangem5t is bas$ on 
a reasonable me?odology & ! entity      
provides docum5tation to ! ,/ate        
suffici5t to enable ! ,/ate & !         
,secret>y to ensure compliance )        
subclause 7,i74  4  7#b7 ,con=m+ am5dm5t
 ,section #aicb7;f7 ( ! ,social         
,security ,act 7#db ,u4,s4,c4           
#acifu-#b7;f77 is am5d$-- 7,a7 by /rik+ 
section #aijb7;a77#ac77;,c7 & ins]t+    
subsections 7,c7 & 7,d7 ( section       
#aijb7;a77#ac72 &  7,b7 by ins]t+ &     
clause 7xiv7 ( section #aijc7m77#b77;,a7
 be=e ! p]iod4  #e4 ,,macpac report &   
,,cms guidance on increas+ access to    
d\la s]vices = ,m$icaid b5efici>ies  7a7
 ,,macpac ,report  7#a7 ,9 g5]al ,n lat]
 ?an #a ye> aft] ! date ( ! enactm5t (  
?is ,act1 ! ,m$icaid & ,,*ip ,paym5t &  

,access ,commission 7ref]r$ to 9 ?is    
section z ,,macpac7 %all publi% a report
 on ! cov]age ( d\la s]vices "u ,/ate   
,m$icaid programs1 :i* %all at a m9imum 
include ! foll[+3 7,a7 ,in=mation ab\t  
cov]age = d\la s]vices "u ,/ate ,m$icaid
 programs t curr5tly provide cov]age =  
su* c>e1 includ+ ! type ( d\la s]vices  
(f]$ 7su* z pr5atal1 labor & deliv]y1   
po/p>tum support1 & community-bas$ &    
traditional d\la s]vices71 cr$5tial+ &  
provid] enrollm5t requirem5ts = d\las "u
 ,/ate ,m$icaid programs1 additional =ms
 ( support contribut+ to d\la enrollm5t 
& reimbursem5t "u ,/ate ,m$icaid        
programs1 & data on outcomes ) respect  
to d\la s]vices "u ea* ,/ate ,m$icaid   
program1 includ+ ! numb] ( d\las regi/]$
 "u ! ,/ate ,m$icaid program1 ! numb] ( 
pregnant1 bir?+1 & po/p>tum individuals 
s]v$ by d\las "u ! ,/ate ,m$icaid       
program1 & ! am\nt ( "t x takes = d\las 
to receive paym5t "u ! ,/ate ,m$icaid   
program = s]vices provid$ "u ! program4 
7,b7 ,an analysis ( b>ri]s to cov]+ d\la

 s]vices "u ,/ate ,m$icaid programs4    
7,c7 ,an id5tification ( effective      
/rategies to increase ! use ( d\la      
s]vices 9 ord] to provide bett] c>e &   
a*ieve bett] mat]nal & infant heal?     
outcomes1 includ+ /rategies t ,/ates may
 use to recruit1 tra91 su/a91 & c]tify a
 div]se d\la work=ce1 p>ticul>ly f      
und]s]v$ communities1 communities (     
color1 & communities fac+ l+ui/ic or    
cultural b>ri]s4  7,d7 ,recomm5dations =
 legislative & adm9i/rative actions to  
increase access to d\la s]vices 9 ,/ate 
,m$icaid programs1 includ+ actions t    
ensure d\las may e>n a su/a9able liv+   
wage t acc\nts = _! "t & co/s associat$ 
) provid+ c>e & community-bas$ d\la     
program adm9i/ration & op]ation4  7#b7  
,/akehold] consultation ,9 develop+ !   
report requir$ "u p>agraph 7#a71        
,,macpac %all consult ) relevant        
/akehold]s1 includ+-- 7,a7 ,/ates2  7,b7
 organizations1 especially reproductive 
ju/ice & bir? ju/ice organizations l$ by
 p ( color1 repres5t+ consum]s ( mat]nal

 heal? c>e1 includ+ ^? t are            
disproportionately impact$ by poor      
mat]nal heal? outcomes2  7,c7           
organizations & individuals repres5t+   
d\las1 includ+ community-bas$ d\la      
programs & ^? :o s]ve und]s]v$          
communities1 includ+ communities (      
color1 & communities fac+ l+ui/ic or    
cultural b>ri]s2  7,d7 organizations    
repres5t+ heal? c>e provid]s2 &  7,e7   
,black1 ,indig5\s1 & o!r mat]nal heal?  
c>e consum]s ( color :o h exp]i5c$ sev]e
 mat]nal morbidity4  7b7 ,,cms guidance 
7#a7 ,9 g5]al ,n lat] ?an #a ye> aft] ! 
date t ,,macpac publi%es ! report       
requir$ "u subsection 7a77#a71 !        
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices %all issue guidance to
 ,/ates on increas+ access to d\la      
s]vices "u ,m$icaid4 ,su* guidance %all 
at a m9imum include-- 7,a7 options =    
,/ates to provide m$ical assi/ance =    
d\la s]vices "u ,/ate ,m$icaid programs2
  7,b7 be/ practices = ensur+ t d\las1  
includ+ community-bas$ d\las1 receive   

reimbursem5t = d\la s]vices provid$ "u a
 ,/ate ,m$icaid program1 at a level t   
all[s d\las to e>n a liv+ wage t acc\nts
 = _! "t & co/s associat$ ) provid+ c>e 
& community-bas$ d\la program           
adm9i/ration2 &  7,c7 be/ practices =   
increas+ access to d\la s]vices1 includ+
 s]vices provid$ by community-bas$      
d\las1 "u ,/ate ,m$icaid programs4  7#b7
 ,/akehold] consultation ,9 develop+ !  
guidance requir$ "u p>agraph 7#a71 !    
,adm9i/rator ( ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices %all consult )        
,,macpac & o!r relevant /akehold]s1     
includ+-- 7,a7 ,/ate ,m$icaid (ficials2 
7,b7 organizations repres5t+ consum]s ( 
mat]nal heal? c>e1 includ+ ^? t are     
disproportionately impact$ by poor      
mat]nal heal? outcomes2  7,c7           
organizations repres5t+ d\las1 includ+  
community-bas$ d\las & ^? :o s]ve       
und]s]v$ communities1 su* z communities 
( color & communities fac+ l+ui/ic or   
cultural b>ri]s2  7,d7 organizations    
repres5t+ m$ical pr(essionals2 &  7,e7  

mat]nal heal? advocacy organizations4   
#f4 ,,gao report on ,/ate ,m$icaid      
programs' use ( teleheal? to increase   
access to mat]nity c>e ,n lat] ?an #a   
ye> aft] ! date ( ! enactm5t ( ?is ,act1
 ! ,comptroll] ,g5]al ( ! ,unit$ ,/ates 
%all submit a report to ,congress on    
,/ate ,m$icaid programs' use ( teleheal?
 to increase access to mat]nity c>e4    
,su* report %all include ! foll[+3 7#a7 
,! numb] ( ,/ate ,m$icaid programs t    
utilize teleheal? t increases access to 
mat]nity c>e4  7#b7 ,) respect to ,/ate 
,m$icaid programs t utilize teleheal? t 
increases access to mat]nity c>e1       
in=mation ab\t-- 7,a7 common *>act]i/ics
 ( su* programs' approa*es to utiliz+   
teleheal? t increases access to mat]nity
 c>e2  7,b7 diff]5ces 9 ,/ates'         
approa*es to utiliz+ teleheal? to       
improve access to mat]nity c>e1 & !     
result+ diff]5ces 9 ,/ate mat]nal heal? 
outcomes1 z det]m9$ by factors describ$ 
9 subsection 7,c72 &  7,c7 :5 comp>$ to 
pati5ts :o receive mat]nity c>e 9-p]son1

 :at is kn[n ab\t-- 7i7 ! demographic   
*>act]i/ics1 su* z race1 e?nicity1 sex1 
sexual ori5tation1 g5d] id5tity1        
disability /atus1 age1 & pref]r$        
language ( ! individuals enroll$ 9 su*  
programs :o use teleheal? to access     
mat]nity c>e2  7ii7 heal? outcomes = su*
 individuals1 includ+ frequ5cy (        
mortality & sev]e morbidity1 z comp>$ to
 individuals ) simil> *>act]i/ics :o did
 n use teleheal? to access mat]nity c>e2
  7iii7 ! s]vices provid$ to individuals
 ?r\gh teleheal?1 includ+ family plann+ 
s]vices1 m5tal heal? c>e s]vices1 & oral
 heal? s]vices2  7iv7 ! devices &       
equipm5t provid$ to individuals = remote
 pati5t monitor+ & teleheal?1 includ+   
blood pressure monitors & blood glucose 
monitors2  7v7 ! quality ( mat]nity c>e 
provid$ ?r\gh teleheal?1 includ+ :e!r   
mat]nity c>e provid$ ?r\gh teleheal? is 
culturally & l+ui/ically appropriate2   
7vi7 ! level ( pati5t satisfaction ) an 
exp]i5ce ( mat]nity c>e provid$ ?r\gh   
teleheal? to individuals enroll$ 9 ,/ate

 ,m$icaid programs2  7vii7 ! impact (   
utiliz+ teleheal? to increase access to 
mat]nity c>e on sp5d+1 co/ sav+s1 access
 to c>e1 & utilization ( c>e "u ,/ate   
,m$icaid programs2 &  7viii7 !          
accessibility & effectiv5ess ( teleheal?
 = mat]nity c>e dur+ ! ,,covid-#ai      
p&emic4  7#c7 ,an id5tification &       
analysis ( ! b>ri]s to us+ teleheal? to 
increase access to mat]nity c>e "u ,/ate
 ,m$icaid programs4  7#d7               
,recomm5dations = su* legislative &     
adm9i/rative actions relat$ to increas+ 
access to teleheal? mat]nity s]vices "u 
,m$icaid z ! ,comptroll] ,g5]al deems   
appropriate4