Maternal Health Accountability Act of 2014 - Amends title V (Maternal and Child Health Services) of the Social Security Act to direct the Secretary of Health and Human Services (HHS) to award grants to states for: (1) mandatory reporting to the state department of health by health care providers and other entities of pregnancy-related deaths; (2) establishment of a state maternal mortality review committee on pregnancy-related deaths occurring within such state; (3) implementation and use of the comprehensive case abstraction form by such committee to preserve the uniformity of the information collected; (4) annual public disclosure of committee findings; and (5) collect, analyze, and report to the Secretary cases of maternal morbidity.
Directs the Secretary, acting through the Director of the National Institutes of Health (NIH), to: (1) organize a national workshop to identify definitions for severe maternal morbidity and make recommendations for a research plan to identify and monitor such morbidity in the United States; and (2) develop uniform definitions of severe maternal morbidity, a research plan, and possible data collection protocols to assist states in identifying and monitoring such cases.
Amends the Public Health Service Act to direct the Secretary to carry out specified research and demonstration activities to eliminate disparities in maternal health outcomes.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4216 Introduced in House (IH)]
113th CONGRESS
2d Session
H. R. 4216
To amend title V of the Social Security Act to provide grants to States
to establish State maternal mortality review committees on pregnancy-
related deaths occurring within such States; to develop definitions of
severe maternal morbidity and data collection protocols; and to
eliminate disparities in maternal health outcomes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 12, 2014
Mr. Conyers (for himself and Ms. DeGette) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend title V of the Social Security Act to provide grants to States
to establish State maternal mortality review committees on pregnancy-
related deaths occurring within such States; to develop definitions of
severe maternal morbidity and data collection protocols; and to
eliminate disparities in maternal health outcomes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Maternal Health Accountability Act
of 2014''.
SEC. 2. FINDINGS; PURPOSES.
(a) Findings.--Congress finds the following:
(1) The aggregate pregnancy-related mortality ratio in the
United States as measured by the Centers for Disease Control
and Prevention Pregnancy Mortality Surveillance System was 14.5
for the 8-year period 1998 through 2005, higher than any other
period in the previous 20 years. Although this increase may
reflect changes in data collection methods by the States, this
reported increase, along with no improvement in previous years
remains a source of great concern for the Centers for Disease
Control and Prevention, and registered nurses, health care
providers, and patient advocates such as the Joint Commission,
the American College of Obstetricians and Gynecologists, and
Amnesty International.
(2) The Centers for Disease Control and Prevention has
found that maternal deaths should be investigated through
State-based maternal death reviews and maternal quality
collaboratives, as these entities are well-situated to identify
deaths, review the factors associated with them, and take
action with the findings in order to institute the systemic
changes needed to decrease pregnancy-related and pregnancy-
associated mortality.
(3) Women of color and low-income women face added risks in
terms of death, complications, and access to quality health
care. African-American women are three to four times more
likely to die of pregnancy-related complications than White
women. In 2006 the Centers for Disease Control and Prevention
reported that the maternal mortality ratio for non-Hispanic
White women was 9.1 deaths per 100,000 births compared with
34.8 deaths per 100,000 births for non-Hispanic Black women.
These rates and disparities have not improved in more than 20
years.
(4) Healthy People 2010, a comprehensive, nationwide health
promotion and disease prevention agenda launched by the
Department of Health and Human Services, set a target goal of
reducing maternal mortality in the United States to 4.3 deaths
per 100,000 live births by 2010. In 2007, the national maternal
mortality ratio was 12.7 deaths per 100,000 live births.
(5) Severe complications that result in women nearly dying,
known as a ``near miss'' or severe maternal morbidity has
increased by 75 percent for delivery (based on data comparing
1998 through 1999) and 114 percent for postpartum
hospitalizations (based on data comparing 2008 through 2009).
Such data also estimates that severe morbidity affects 52,000
women a year and is expected to continue to increase. Moreover,
there is no scientific consensus on uniform definitions of
severe maternal morbidity and best practices for data
collection, making it difficult to measure the full extent of
severe morbidity and developing evidence-based interventions.
(b) Purposes.--The purposes of this Act are the following:
(1) To establish governmental accountability and a shared
responsibility between States and the Federal Government to
identify opportunities for improvement in quality of care and
system changes, and to educate and inform health institutions
and professionals, women, and families about preventing
pregnancy-related deaths and complications and reducing
disparities.
(2) To develop a model for States to operate maternal
mortality reviews and assess the various factors that may have
contributed to maternal mortality, including quality of care,
racial disparities, and systemic problems in the delivery of
health care, and to develop appropriate interventions to reduce
and prevent such deaths.
SEC. 3. UNIFORM STATE MATERNAL MORTALITY REVIEW COMMITTEES ON
PREGNANCY-RELATED DEATHS.
(a) Condition of Receipt of Payments From Allotment Under Maternal
and Child Health Service Block Grant.--Title V of the Social Security
Act (42 U.S.C. 701 et seq.) is amended by adding at the end the
following new section:
``SEC. 514. UNIFORM STATE MATERNAL MORTALITY REVIEW COMMITTEES ON
PREGNANCY-RELATED DEATHS.
``(a) Grants.--
``(1) In general.--Notwithstanding any other provision of
this title, for each of fiscal years 2015 through 2021, in
addition to payments from allotments for States under section
502 for such year, the Secretary shall, subject to paragraph
(3) and in accordance with the criteria established under
paragraph (2), award grants to States to--
``(A) carry out the activities described in
subsection (b)(1);
``(B) establish a State maternal mortality review
committee, in accordance with subsection (b)(2), to
carry out the activities described in subsection
(b)(2)(A), and to establish the processes described in
subsection (b)(1);
``(C) ensure the State department of health carries
out the applicable activities described in subsection
(b)(3), with respect to pregnancy-related deaths
occurring within the State during such fiscal year;
``(D) implement and use the comprehensive case
abstraction form developed under subsection (c), in
accordance with such subsection;
``(E) provide for public disclosure of information,
in accordance with subsection (e); and
``(F) collect, analyze, and report to the Secretary
cases of maternal morbidity, including reports of
maternal morbidity data on admissions to an intensive
care unit or the transfusion of more than three units
of blood products.
``(2) Criteria.--The Secretary shall establish criteria for
determining eligibility for and the amount of a grant awarded
to a State under paragraph (1). Such criteria shall provide
that in the case of a State that receives such a grant for a
fiscal year and is determined by the Secretary to have not used
such grant in accordance with this section, such State shall
not be eligible for such a grant for any subsequent fiscal
year.
``(3) Authorization of appropriations.--For purposes of
carrying out the grant program under this section, including
for administrative purposes, there is authorized to be
appropriated $10,000,000 for each of fiscal years 2015 through
2021.
``(b) Pregnancy-Related Death Review.--
``(1) Review of pregnancy-related death and pregnancy-
associated death cases.--For purposes of subsection (a), with
respect to a State that receives a grant under subsection (a),
the following shall apply:
``(A) Mandatory reporting of pregnancy-related
deaths.--
``(i) In general.--The State shall, through
the State maternal mortality review committee,
develop a process, separate from any reporting
process established by the State department of
health prior to the date of the enactment of
this section, that provides for mandatory and
confidential case reporting by individuals and
entities described in clause (ii) of pregnancy-
related deaths to the State department of
health.
``(ii) Individuals and entities
described.--Individuals and entities described
in this clause include each of the following:
``(I) Health care providers.
``(II) Medical examiners.
``(III) Medical coroners.
``(IV) Hospitals.
``(V) Free-standing birth centers.
``(VI) Other health care
facilities.
``(VII) Any other individuals
responsible for completing death
certificates.
``(VIII) Any other appropriate
individuals or entities specified by
the Secretary.
``(B) Voluntary reporting of pregnancy-related and
pregnancy-associated deaths.--
``(i) The State shall, through the State
maternal mortality review committee, develop a
process for and encourage, separate from any
reporting process established by the State
department of health prior to the date of the
enactment of this section, voluntary and
confidential case reporting by individuals
described in clause (ii) of pregnancy-
associated deaths to the State department of
health.
``(ii) The State shall, through the State
maternal mortality review committee, develop a
process for voluntary and confidential
reporting by family members of the deceased and
by other individuals on possible pregnancy-
related and pregnancy-associated deaths to the
State department of health. Such process shall
include--
``(I) making publicly available on
the Internet Web site of the State
department of health a telephone
number, Internet Web link, and email
address for such reporting; and
``(II) publicizing to local
professional organizations, community
organizations, and social services
agencies the availability of the
telephone number, Internet Web link,
and email address made available under
subclause (I).
``(C) Development of case-finding.--The State,
through the vital statistics unit of the State, shall
annually identify pregnancy-related and pregnancy-
associated deaths occurring in such State during the
year involved by--
``(i) matching all death records, with
respect to such year, for women of childbearing
age to live birth certificates and infant death
certificates to identify deaths of women that
occurred during pregnancy and within one year
after the end of a pregnancy;
``(ii) identifying deaths reported during
such year as having an underlying or
contributing cause of death related to
pregnancy, regardless of the time that has
passed between the end of the pregnancy and the
death;
``(iii) collecting data from medical
examiner and coroner reports; and
``(iv) any other methods the States may
devise to identify maternal deaths, such as
through review of a random sample of reported
deaths of women of childbearing age to
ascertain cases of pregnancy-related and
pregnancy-associated deaths that are not
discernable from a review of death certificates
alone.
When feasible and for purposes of effectively
collecting and obtaining data on pregnancy-related and
pregnancy-associated deaths, the State shall adopt the
most recent standardized birth and death certificates,
as issued by the National Center for Vital Health
Statistics, including the recommended checkbox section
for pregnancy on the death certificates.
``(D) Case investigation and development of case
summaries.--Following receipt of reports by the State
department of health pursuant to subparagraph (A) or
(B) and collection by the vital statistics unit of the
State of possible cases of pregnancy-related and
pregnancy-associated deaths pursuant to subparagraph
(C), the State, through the State maternal mortality
review committee established under subsection (a),
shall investigate each case, utilizing the case
abstraction form described in subsection (c), and
prepare de-identified case summaries, which shall be
reviewed by the committee and included in applicable
reports. For purposes of subsection (a), under the
processes established under subparagraphs (A), (B), and
(C), a State department of health or vital statistics
unit of a State shall provide to the State maternal
mortality review committee access to information
collected pursuant to such subparagraphs as necessary
to carry out this subparagraph. Data and information
collected for the case summary and review are for
purposes of public health activities, in accordance
with HIPAA privacy and security law (as defined in
section 3009(a)(2) of the Public Health Service Act).
Such case investigations shall include data and
information obtained through--
``(i) medical examiner and autopsy reports
of the woman involved;
``(ii) medical records of the woman,
including such records related to health care
prior to pregnancy, prenatal and postnatal
care, labor and delivery care, emergency room
care, hospital discharge records, and any care
delivered up until the time of death of the
woman for purposes of public health activities,
in accordance with HIPAA privacy and security
law (as defined in section 3009(a)(2) of the
Public Health Service Act);
``(iii) oral and written interviews of
individuals directly involved in the maternal
care of the woman during and immediately
following the pregnancy of the woman, including
health care, mental health, and social service
providers, as applicable;
``(iv) optional oral or written interviews
of the family of the woman;
``(v) socioeconomic and other relevant
background information about the woman;
``(vi) information collected in
subparagraph (C)(i); and
``(vii) other information on the cause of
death of the woman, such as social services and
child welfare reports.
``(2) State maternal mortality review committees.--
``(A) Duties.--
``(i) Required committee activities.--For
purposes of subsection (a), a maternal
mortality review committee established by a
State pursuant to a grant under such subsection
shall carry out the following pregnancy-related
death and pregnancy-associated death review
activities and shall include all information
relevant to the death involved on the case
abstraction form developed under subsection
(d):
``(I) With respect to a case of
pregnancy-related or pregnancy-
associated death of a woman, review the
case summaries prepared under
subparagraphs (A), (B), (C), and (D) of
paragraph (1).
``(II) Review aggregate statistical
reports developed by the vital
statistics unit of the State under
paragraph (1)(C) regarding pregnancy-
related and pregnancy-associated deaths
to identify trends, patterns, and
disparities in adverse outcomes and
address medical, non-medical, and
system-related factors that may have
contributed to such pregnancy-related
and pregnancy-associated deaths and
disparities.
``(III) Develop recommendations,
based on the review of the case
summaries under paragraph (1)(D) and
aggregate statistical reports under
subclause (II), to improve maternal
care, social and health services, and
public health policy and institutions,
including with respect to improving
access to maternal care, improving the
availability of social services, and
eliminating disparities in maternal
care and outcomes.
``(ii) Optional committee activities.--For
purposes of subsection (a), a maternal
mortality review committee established by a
State under such subsection may present
findings and recommendations regarding a
specific case or set of circumstances directly
to a health care facility or its local or State
professional organization for the purpose of
instituting policy changes, educational
activities, or otherwise improving the quality
of care provided by the facilities.
``(B) Composition of maternal mortality review
committees.--
``(i) In general.--Each State maternal
mortality review committee established pursuant
to a grant under subsection (a) shall be multi-
disciplinary, consisting of health care and
social service providers, public health
officials, other persons with professional
expertise on maternal health and mortality, and
patient and community advocates who represent
those communities within such State that are
the most affected by maternal mortality.
Membership on such a committee of a State shall
be reviewed annually by the State department of
health to ensure that membership representation
requirements are being fulfilled in accordance
with this paragraph.
``(ii) Required membership.--Each such
review committee shall include--
``(I) representatives from medical
specialities providing care to pregnant
and postpartum patients, including
obstetricians (including generalists
and maternal fetal medicine
specialists), and family practice
physicians;
``(II) certified nurse midwives,
certified midwives, and advanced
practice nurses;
``(III) hospital-based registered
nurses;
``(IV) representatives of the State
department of health maternal and child
health department;
``(V) social service providers or
social workers;
``(VI) the chief medical examiners
or designees;
``(VII) facility representatives,
such as from hospitals or free-standing
birth centers; and
``(VIII) community or patient
advocates who represent those
communities within the State that are
the most affected by maternal
mortality.
``(iii) Additional members.--Each such
review committee may also include
representatives from other relevant academic,
health, social service, or policy professions,
or community organizations, on an ongoing
basis, or as needed, as determined beneficial
by the review committee, including--
``(I) anesthesiologists;
``(II) emergency physicians;
``(III) pathologists;
``(IV) epidemiologists or
biostatisticians;
``(V) intensivists;
``(VI) vital statistics officers;
``(VII) nutritionists;
``(VIII) mental health
professionals;
``(IX) substance abuse treatment
specialists;
``(X) representatives of relevant
advocacy groups;
``(XI) academics;
``(XII) representatives of
beneficiaries of the State plan under
the Medicaid program under title XIX;
``(XIII) paramedics;
``(XIV) lawyers;
``(XV) risk management specialists;
``(XVI) representatives of the
departments of health or public health
of major cities in the State involved;
and
``(XVII) policy makers.
``(iv) Diverse community membership.--The
composition of such a committee, with respect
to a State, shall include--
``(I) representatives from diverse
communities, particularly those
communities within such State most
severely affected by pregnancy-related
deaths or pregnancy-associated deaths
and by a lack of access to relevant
maternal care services, from community
maternal child health organizations,
and from minority advocacy groups;
``(II) members, including health
care providers, from different
geographic regions in the State,
including any rural, urban, and tribal
areas; and
``(III) health care and social
service providers who work in
communities that are diverse with
regard to race, ethnicity, immigration
status, Indigenous status, and English
proficiency.
``(v) Maternal mortality review staff.--
Staff of each such review committee shall
include--
``(I) vital health statisticians,
maternal child health statisticians, or
epidemiologists;
``(II) a coordinator of the State
maternal mortality review committee, to
be designated by the State; and
``(III) administrative staff.
``(C) Option for states to form regional maternal
mortality reviews.--States with a low rate of
occurrence of pregnancy-associated or pregnancy-related
deaths may choose to partner with one or more
neighboring States to fulfill the activities described
in paragraph (1)(C). In such a case, with respect to
States in such a partnership, any requirement under
this section relating to the reporting of information
related to such activities shall be deemed to be
fulfilled by each such State if a single such report is
submitted for the partnership.
``(3) State department of health activities.--For purposes
of subsection (a), a State department of health of a State
receiving a grant under such subsection shall--
``(A) in consultation with the maternal mortality
review committee of the State and in conjunction with
relevant professional organizations, develop a plan for
ongoing health care provider education, based on the
findings and recommendations of the committee, in order
to improve the quality of maternal care; and
``(B) take steps to widely disseminate the findings
and recommendations of the State maternal mortality
review committees of the State and to implement the
recommendations of such committee.
``(c) Case Abstraction Form.--
``(1) Development.--The Director of the Centers for Disease
Control and Prevention shall develop a uniform, comprehensive
case abstraction form and make such form available to States
for State maternal mortality review committees for use by such
committees in order to--
``(A) ensure that the cases and information
collected and reviewed by such committees can be pooled
for review by the Department of Health and Human
Services and its agencies; and
``(B) preserve the uniformity of the information
and its use for Federal public health purposes.
``(2) Permissible state modification.--Each State may
modify the form developed under paragraph (1) for
implementation and use by such State or by the State maternal
mortality review committee of such State by including on such
form additional information to be collected, but may not alter
the standard questions on such form, in order to ensure that
the information can be collected and reviewed centrally at the
Federal level.
``(d) Treatment as Public Health Authority for Purposes of HIPAA.--
For purposes of applying HIPAA privacy and security law (as defined in
section 3009(a)(2) of the Public Health Service Act), a State maternal
mortality review committee of a State established pursuant to this
section to carry out activities described in subsection (b)(2)(A) shall
be deemed to be a public health authority described in section 164.501
(and referenced in section 164.512(b)(1)(i)) of title 45, Code of
Federal Regulations (or any successor regulation), carrying out public
health activities and purposes described in such section
164.512(b)(1)(i) (or any such successor regulation).
``(e) Public Disclosure of Information.--
``(1) In general.--For fiscal year 2015 or a subsequent
fiscal year, each State receiving a grant under this section
for such year shall, subject to paragraph (3), provide for the
public disclosure, and submission to the information
clearinghouse established under paragraph (2), of the
information included in the report of the State under section
506(a)(2)(F) for such year (relating to the findings for such
year of the State maternal mortality review committee
established by the State under this section).
``(2) Information clearinghouse.--The Secretary of Health
and Human Services shall establish an information
clearinghouse, that shall be administered by the Director of
the Centers for Disease Control and Prevention, that will
maintain findings and recommendations submitted pursuant to
paragraph (1) and provide such findings and recommendations for
public review and research purposes by State health
departments, maternal mortality review committees, and health
providers and institutions.
``(3) Confidentiality of information.--In no case shall any
individually identifiable health information be provided to the
public, or submitted to the information clearinghouse, under
paragraph (1).
``(f) Confidentiality of Review Committee Proceedings.--
``(1) In general.--All proceedings and activities of a
State maternal mortality review committee under this section,
opinions of members of such a committee formed as a result of
such proceedings and activities, and records obtained, created,
or maintained pursuant to this section, including records of
interviews, written reports, and statements procured by the
Department of Health and Human Services or by any other person,
agency, or organization acting jointly with the Department, in
connection with morbidity and mortality reviews under this
section, shall be confidential, and not subject to discovery,
subpoena, or introduction into evidence in any civil, criminal,
legislative, or other proceeding. Such records shall not be
open to public inspection.
``(2) Testimony of members of committee.--
``(A) In general.--Members of a State maternal
mortality review committee under this section may not
be questioned in any civil, criminal, legislative, or
other proceeding regarding information presented in, or
opinions formed as a result of, a meeting or
communication of the committee.
``(B) Clarification.--Nothing in this subsection
shall be construed to prevent a member of such a
committee from testifying regarding information that
was obtained independent of such member's participation
on the committee, or that is public information.
``(3) Availability of information for research purposes.--
Nothing in this subsection shall prohibit the publishing by
such a committee or the Department of Health and Human Services
of statistical compilations and research reports that--
``(A) are based on confidential information,
relating to morbidity and mortality review; and
``(B) do not contain identifying information or any
other information that could be used to ultimately
identify the individuals concerned.
``(g) Definitions.--For purposes of this section:
``(1) The term `pregnancy-associated death' means the death
of a woman while pregnant or during the one-year period
following the date of the end of pregnancy, irrespective of the
cause of such death.
``(2) The term `pregnancy-related death' means the death of
a woman while pregnant or during the one-year period following
the date of the end of pregnancy, irrespective of the duration
or site of the pregnancy, from any cause related to or
aggravated by the pregnancy or its management, but not from any
accidental or incidental cause.
``(3) The term `woman of childbearing age' means a woman
who is at least 10 years of age and not more than 54 years of
age.''.
(b) Inclusion of Findings of Review Committees in Required
Reports.--
(1) State triennial reports.--Paragraph (2) of section
506(a) of such Act (42 U.S.C. 706(a)) is amended by inserting
after subparagraph (E) the following new subparagraph:
``(F) In the case of a State receiving a grant
under section 514, beginning for the first fiscal year
beginning after 3 years after the date of establishment
of the State maternal mortality review committee
established by the State pursuant to such grant and
once every 3 years thereafter, information containing
the findings and recommendations of such committee and
information on the implementation of such
recommendations during the period involved.''.
(2) Annual reports to congress.--Paragraph (3) of such
section is amended--
(A) in subparagraph (D), at the end, by striking
``and'';
(B) in subparagraph (E), at the end, by striking
the period and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(F) For fiscal year 2015 and each subsequent
fiscal year, taking into account the findings,
recommendations, and implementation information
submitted by States pursuant to paragraph (2)(F), on
the status of pregnancy-related deaths and pregnancy-
associated deaths in the United States and including
recommendations on methods to prevent such deaths in
the United States.''.
SEC. 4. NIH WORKSHOP AND RESEARCH PLAN DEVELOPMENT ON SEVERE MATERNAL
MORBIDITY.
(a) Workshop.--The Secretary of Health and Human Services, acting
through the Director of NIH and in consultation with the Administrator
of the Health Resources and Services Administration, the Director of
the Centers for Disease Control and Prevention, the heads of other
Federal agencies that administer Federal health programs, and relevant
national professional organizations dealing with maternal morbidity,
shall organize a national workshop to identify definitions for severe
maternal morbidity and make recommendations for a research plan to
identify and monitor severe maternal morbidity in the United States.
(b) Research Plan and Data Collection Protocols.--The Secretary,
taking into account the findings of the workshop under paragraph (1),
shall develop uniform definitions of severe maternal morbidity, a
research plan on severe maternal morbidity, and possible data
collection protocols to assist States in identifying and monitoring
cases of severe maternal morbidity and to develop recommendations on
addressing such cases.
(c) Report.--Not later than 2 years after the date of enactment of
this Act, the Secretary shall prepare and submit to the appropriate
committees of Congress a report concerning the definitions and research
plan developed under this section.
(d) Authorization of Appropriations.--There is authorized to be
appropriated for fiscal year 2015--
(1) $50,000 to carry out subsection (a); and
(2) $100,000 to carry out subsection (b).
SEC. 5. ELIMINATING DISPARITIES IN MATERNITY HEALTH OUTCOMES.
Part B of title III of the Public Health Service Act is amended by
inserting after section 317T of such Act (42 U.S.C. 247b-22) the
following new section:
``SEC. 317U. ELIMINATING DISPARITIES IN MATERNITY HEALTH OUTCOMES.
``(a) In General.--The Secretary shall, in consultation with
relevant national stakeholder organizations, such as national medical
specialty organizations, national maternal child health organizations,
and national health disparity organizations, carry out the following
activities to eliminate disparities in maternal health outcomes:
``(1) Conduct research into the determinants and the
distribution of disparities in maternal care, health risks, and
health outcomes, and improve the capacity of the performance
measurement infrastructure to measure such disparities.
``(2) Expand access to services that have been demonstrated
to improve the quality and outcomes of maternity care for
vulnerable populations.
``(3) Establish a demonstration project to compare the
effectiveness of interventions to reduce disparities in
maternity services and outcomes, and implement and assessing
effective interventions.
``(b) Scope and Selection of States for Demonstration Project.--The
demonstration project under subsection (a)(3) shall be conducted in no
more than 8 States, which shall be selected by the Secretary based on--
``(1) applications submitted by States, which specify which
regions and populations the State involved will serve under the
demonstration project;
``(2) criteria designed by the Secretary to ensure that, as
a whole, the demonstration project is, to the greatest extent
possible, representative of the demographic and geographic
composition of communities most affected by disparities;
``(3) criteria designed by the Secretary to ensure that a
variety of type of models are tested through the demonstration
project and that such models include interventions that have an
existing evidence base for effectiveness; and
``(4) criteria designed by the Secretary to assure that the
demonstration projects and models will be carried out in
consultation with local and regional provider organizations,
such as community health centers, hospital systems, and medical
societies representing providers of maternity services.
``(c) Duration of Demonstration Project.--The demonstration project
under subsection (a)(3) shall begin on January 1, 2015, and end on
December 31, 2019.
``(d) Grants for Evaluation and Monitoring.--The Secretary may make
grants to States and health care providers participating in the
demonstration project under subsection (a)(3) for the purpose of
collecting data necessary for the evaluation and monitoring of such
project.
``(e) Reports.--
``(1) State reports.--Each State that participates in the
demonstration project under subsection (a)(3) shall report to
the Secretary, in a time, form, and manner specified by the
Secretary, the data necessary to--
``(A) monitor the--
``(i) outcomes of the project;
``(ii) costs of the project; and
``(iii) quality of maternity care provided
under the project; and
``(B) evaluate the rationale for the selection of
the items and services included in any bundled payment
made by the State under the project.
``(2) Final report.--Not later than December 31, 2020, the
Secretary shall submit to Congress a report on the results of
the demonstration project under subsection (a)(3).''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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