Innovative Maternal Payment And Coverage To Save Moms Act or the IMPACT to Save Moms Act of 2020
This bill requires the Centers for Medicare & Medicaid Services to establish the Perinatal Care Alternative Payment Model Demonstration Project to allow states to test payment models for maternity care, including postpartum care, under Medicaid and the Children's Health Insurance Program (CHIP).
Additionally, the Medicaid and CHIP Payment and Access Commission must report on specified information relating to the continuity of coverage for pregnant and postpartum women under Medicaid and CHIP.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6137 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 6137
To require the Secretary of Health and Human Services to establish and
implement a Perinatal Care Alternative Payment Model Demonstration
Project, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 9, 2020
Ms. Schakowsky (for herself, Ms. Underwood, Ms. Adams, Ms. Scanlon, Ms.
Norton, Ms. Sewell of Alabama, Mr. Khanna, Ms. Bass, Ms. Moore, Mr.
Clay, Mr. Lawson of Florida, and Ms. Pressley) introduced the following
bill; which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To require the Secretary of Health and Human Services to establish and
implement a Perinatal Care Alternative Payment Model Demonstration
Project, and for other purposes.
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 ``Innovative Maternal Payment And
Coverage To Save Moms Act'' or the ``IMPACT to Save Moms Act of 2020''.
SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION PROJECT.
(a) In General.--For the period of fiscal years 2022 through 2026,
the Secretary of Health and Human Services (referred to in this section
as the ``Secretary''), acting through the Administrator of the Centers
for Medicare & Medicaid Services, shall establish and implement, in
accordance with the requirements of this section, a demonstration
project, to be known as the Perinatal Care Alternative Payment Model
Demonstration Project (referred to in this section as the
``Demonstration Project''), for purposes of allowing States to test
payment models under their State plans under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) and State child health plans
under title XXI of such Act (42 U.S.C. 1397aa et seq.) with respect to
maternity care provided to pregnant and postpartum women enrolled in
such State plans and State child health plans.
(b) Coordination.--In establishing the Demonstration Project, the
Secretary shall coordinate with stakeholders such as--
(1) State Medicaid programs;
(2) relevant organizations representing maternal health
care providers;
(3) relevant organizations representing patients, with a
particular focus on women from demographic groups with
disproportionate rates of adverse maternal health outcomes;
(4) relevant community-based organizations, particularly
organizations that seek to improve maternal health outcomes for
women from demographic groups with disproportionate rates of
adverse maternal health outcomes;
(5) non-clinical perinatal health workers such as doulas,
community health workers, peer supporters, certified lactation
consultants, nutritionists and dieticians, social workers, home
visitors, and navigators;
(6) relevant health insurance issuers;
(7) hospitals, health systems, freestanding birth centers
(as such term is defined in paragraph (3)(B) of section 1905(l)
of the Social Security Act (42 U.S.C. 1396d(l))), federally
qualified health centers (as such term is defined in paragraph
(2)(B) of such section), and rural health clinics (as such term
is defined in section 1861(aa) of such Act (42 U.S.C.
1395x(aa)));
(8) researchers and policy experts in fields related to
maternity care payment models; and
(9) any other stakeholders as the Secretary determines
appropriate, with a particular focus on stakeholders from
demographic groups with disproportionate rates of adverse
maternal health outcomes.
(c) Considerations.--In establishing the Demonstration Project, the
Secretary shall consider each of the following:
(1) Findings from any evaluations of the Strong Start for
Mothers and Newborns initiative carried out by the Centers for
Medicare & Medicaid Services, the Health Resources and Services
Administration, and the Administration on Children and
Families.
(2) Any alternative payment model that--
(A) is designed to improve maternal health outcomes
for racial and ethnic groups with disproportionate
rates of adverse maternal health outcomes;
(B) includes methods for stratifying patients by
pregnancy risk level and, as appropriate, adjusting
payments under such model to take into account
pregnancy risk level;
(C) establishes evidence-based quality metrics for
such payments;
(D) includes consideration of non-hospital birth
settings such as freestanding birth centers (as so
defined);
(E) includes consideration of social determinants
of health that are relevant to maternal health outcomes
such as housing, transportation, nutrition, and other
non-clinical factors that influence maternal health
outcomes; or
(F) includes diverse maternity care teams that
include--
(i) maternity care providers, including
obstetrician-gynecologists, family physicians,
physician assistants, midwives who meet, at a
minimum, the international definition of the
term ``midwife'' and global standards for
midwifery education (as established by the
International Confederation of Midwives), and
nurse practitioners--
(I) from racially, ethnically, and
professionally diverse backgrounds;
(II) with experience practicing in
racially and ethnically diverse
communities; or
(III) who have undergone trainings
on racism, implicit bias, and explicit
bias; and
(ii) non-clinical perinatal health workers
such as doulas, community health workers, peer
supporters, certified lactation consultants,
nutritionists and dieticians, social workers,
home visitors, and navigators.
(d) Eligibility.--To be eligible to participate in the
Demonstration Project, a State shall submit an application to the
Secretary at such time, in such manner, and containing such information
as the Secretary may require.
(e) Evaluation.--The Secretary shall conduct an evaluation of the
Demonstration Project to determine the impact of the Demonstration
Project on--
(1) maternal health outcomes, with data stratified by race,
ethnicity, socioeconomic indicators, and any other factors as
the Secretary determines appropriate;
(2) spending on maternity care by States participating in
the Demonstration Project;
(3) to the extent practicable, subjective measures of
patient experience; and
(4) any other areas of assessment that the Secretary
determines relevant.
(f) Report.--Not later than one year after the completion or
termination date of the Demonstration Project, the Secretary shall
submit to the Committee on Energy and Commerce, the Committee on Ways
and Means, and the Committee on Education and Labor of the House of
Representatives and the Committee on Finance and the Committee on
Health, Education, Labor, and Pensions of the Senate, and make publicly
available, a report containing--
(1) the results of any evaluation conducted under
subsection (e); and
(2) a recommendation regarding whether the Demonstration
Project should be continued after fiscal year 2026 and expanded
on a national basis.
(g) Authorization of Appropriations.--There are authorized to be
appropriated such sums as are necessary to carry out this section.
(h) Definitions.--In this section:
(1) Alternative payment model.--The term ``alternative
payment model'' has the meaning given such term in section
1833(z)(3)(C) of the Social Security Act (42 U.S.C.
1395l(z)(3)(C)).
(2) Perinatal.--The term ``perinatal'' means the period
beginning on the day a woman becomes pregnant and ending on the
last day of the 1-year period beginning on the last day of such
woman's pregnancy.
SEC. 3. MACPAC REPORT.
(a) In General.--Not later than two years after the date of the
enactment of this Act, the Medicaid and CHIP Payment and Access
Commission shall publish a report on issues relating to the continuity
of coverage under State plans under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) and State child health plans under title
XXI of such Act (42 U.S.C. 1397aa et seq.) for pregnant and postpartum
women. Such report shall, at a minimum, include the following:
(1) An assessment of any existing policies under such State
plans and such State child health plans regarding presumptive
eligibility for pregnant women while their application for
enrollment in such a State plan or such a State child health
plan is being processed.
(2) An assessment of any existing policies under such State
plans and such State child health plans regarding measures to
ensure continuity of coverage under such a State plan or such a
State child health plan for pregnant and postpartum women,
including such women who need to change their health insurance
coverage during their pregnancy or the postpartum period
following their pregnancy.
(3) An assessment of any existing policies under such State
plans and such State child health plans regarding measures to
automatically reenroll women who are eligible to enroll under
such a State plan or such a State child health plan as a
parent.
(4) If determined appropriate by the Commission, any
recommendations for the Department of Health and Human
Services, or such State plans and such State child health
plans, to ensure continuity of coverage under such a State plan
or such a State child health plan for pregnant and postpartum
women.
(b) Postpartum Defined.--In this section, the term ``postpartum''
means the 1-year period beginning on the last day of a woman's
pregnancy.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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