Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1696590922262.pdf (United States)
II 115TH CONGRESS 2D SESSION S. 3392 To address maternal mortality and morbidity.

IN THE SENATE OF THE UNITED STATES AUGUST 28, 2018 Mrs. GILLIBRAND (for herself, Mr. BOOKER, and Ms. HARRIS) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To address maternal mortality and morbidity.
Be it enacted by the Senate and House of Representa- tives of the United States of America in Congress assembled, SECTION 1.

SHORT TITLE.

This Act may be cited as the ‘‘Modernizing Obstetric Medicine Standards Act of 2018’’ or the ‘‘MOMS Act’’.

SEC.

2.

MATERNAL MORTALITY AND MORBIDITY PREVEN- TION.

Section 317K of the Public Health Service Act (42 U.S.C.
247b–12) is amended— (1) by redesignating subsection (d) as sub- section (g); and (2) by inserting after subsection (c) the fol- lowing: ‘‘(d) PREGNANCY AND POSTPARTUM SAFETY AND MONITORING PRACTICES AND MATERNAL MORTALITY AND MORBIDITY PREVENTION.— ‘‘(1) ALLIANCE FOR INNOVATION ON MATERNAL HEALTH.—The Secretary, acting through the Asso- ciate Administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, shall establish a program, known as the Alliance for Innovation on Maternal Health pro- gram, to— ‘‘(A) enter into a contract with an inter- disciplinary, multi-stakeholder, national organi- zation promulgating a national data-driven ma- ternal safety and quality improvement initiative based on evidence-based best practices to im- prove maternal safety and outcomes; ‘‘(B) assist States with the development and implementation of postpartum safety and monitoring practices and maternal mortality and morbidity prevention, based on the best practices developed under paragraph (2); and ‘‘(C) improve State-specific maternal health outcomes and reduce variation in re- •S 3392 IS sponse to maternity and postpartum care, in order to eliminate preventable maternal mor- tality and severe maternal morbidity.
‘‘(2) BEST PRACTICES.— ‘‘(A) IN GENERAL.—Not later than 1 year after the date of enactment of the Modernizing Obstetric Medicine Standards Act of 2018, the Secretary, acting through the Administrator of the Health Resources and Services Administra- tion, shall work with the contracting entity under paragraph (1)(A) to— ‘‘(i) create and assist State-based col- laborative teams in the implementation of standardized best practices, to be known as ‘maternal safety bundles’, for the purpose of maternal mortality and morbidity pre- vention; and ‘‘(ii) collect and analyze data related to process structure and patient outcomes to drive continuous quality improvement in the implementation of the maternal safety bundles by such State-based teams.
‘‘(B) MATERNAL SAFETY BUNDLES.—The best practices issued under subparagraph (A) may address the following topics: •S 3392 IS ‘‘(i) Obstetric hemorrhage.

‘‘(ii) Maternal mental, behavioral, and emotional health.

‘‘(iii) Maternal venous and thrombo- embolism.


‘‘(iv) Severe hypertension in preg- nancy, including preeclampsia.

‘‘(v) Obstetric care for women with substance abuse disorder.

‘‘(vi) Postpartum care basics for ma- ternal safety.

‘‘(vii) Reduction of racial and ethnic disparities in maternity care.

‘‘(viii) Safe reduction of primary ce- sarean birth.

‘‘(ix) Severe maternal morbidity re- view.

‘‘(x) Support after a severe maternal morbidity event.
‘‘(xi) Ways to empower and listen to women before, during, and after childbirth to ensure better communication between patients and health care providers •S 3392 IS 5 ‘‘(xii) Other leading causes of mater- nal mortality and morbidity, including in- fection or sepsis and cardiomyopathy.
‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— To carry out this subsection, in addition to amounts appropriated under subsection (g), there are author- ized to be appropriated $5,000,000 for each of fiscal years 2019 through 2023.’’.

SEC.

3.

MATERNAL MORTALITY AND MORBIDITY PREVEN- TION GRANTS.

Section 317K of the Public Health Service Act (42 U.S.C.
247b–12), as amended by section 2, is further amended by inserting after subsection (d) the following: ‘‘(e) MATERNAL MORTALITY AND MORBIDITY PRE- VENTION GRANT PROGRAM.— ‘‘(1) IN GENERAL.—The Secretary, acting through the Associate Administrator of the Maternal and Child Health Bureau of the Health Resources and Services Administration, shall award grants to States or hospitals to assist in the development and implementation of the maternal safety bundles de- scribed in subsection (d)(2).
‘‘(2) USE OF FUNDS.— •S 3392 IS 6 ‘‘(A) IN GENERAL.—A State or hospital re- ceiving a grant under this subsection may use such funds— ‘‘(i) to purchase equipment and sup- plies to effectively implement and execute the maternal safety bundles described in subsection (d)(2); and ‘‘(ii) to develop training on, and eval- uation of the effectiveness of, such mater- nal safety bundles.
‘‘(B) PRIORITY USE OF FUNDS FOR STATE GRANTEES.—A State receiving a grant under this subsection shall allocate such funds giving priority to the hospitals in such State that serve high volumes of low-income, at-risk, or rural populations.
‘‘(3) PRIORITIZATION OF GRANT APPLICA- TIONS.—In awarding grants under this subsection, the Secretary shall prioritize applications from States, or hospitals within States, that— ‘‘(A) have a functioning maternal mortality review committee in accordance with best prac- tices promulgated by the Building U.S. Capac- ity to Review and Prevent Maternal Deaths Ini- tiative of the Centers for Disease Control and •S 3392 IS Prevention, the CDC Foundation, and the Asso- ciation of Maternal and Child Health Programs; or ‘‘(B) serve high volumes of low-income, at- risk, or rural populations.
‘‘(4) REPORTING REQUIREMENTS.— ‘‘(A) IN GENERAL.—Not later than 2 years after receipt of a grant under this subsection, each recipient of such a grant shall submit a re- port to the Secretary describing— ‘‘(i) implementation of the maternal safety bundles with use of the grant funds; ‘‘(ii) any incidents of pregnancy-re- lated deaths or pregnancy-associated deaths, and any pregnancy-related com- plications or pregnancy-associated com- plications occurring in the 1-year period prior to implementation of such proce- dures; and ‘‘(iii) any incidents of pregnancy-re- lated deaths or pregnancy-associated deaths, and any pregnancy-related com- plications or pregnancy-associated com- plications occurring after implementation of such procedures.
•S 3392 IS ‘‘(B) PUBLIC AVAILABILITY; REPORT TO CONGRESS.—Within 1 year of receiving the re- ports under subparagraph (A), the Secretary shall— ‘‘(i) make the reports submitted under subparagraph (A) publicly available; and ‘‘(ii) submit a report to Congress that describes the grants awarded under this subsection, the effectiveness of the grant program under this subsection, the activi- ties for which grant funds were used, and any recommendations to further prevent maternal mortality and morbidity.
‘‘(C) AUTHORIZATION OF APPROPRIA- TIONS.—To carry out this subsection, in addi- tion to amounts appropriated under subsection (g), there are authorized to be appropriated $40,000,000 for each of fiscal years 2019 through 2023.
‘‘(f) DEFINITIONS.—In this section— ‘‘(1) the terms ‘pregnancy-associated death’ and ‘pregnancy-associated complication’ mean the death or medical complication, respectively, of a woman that occurs during, or within 1 year following, her •S 3392 IS pregnancy, regardless of the outcome, duration, or site of the pregnancy; ‘‘(2) the terms ‘pregnancy-related death’ and ‘pregnancy-related complication’ mean the death or medical complication, respectively, of a woman that— ‘‘(A) occurs during, or within 1 year fol- lowing, her pregnancy, regardless of the out- come, duration, or site of the pregnancy; ‘‘(B) is from any cause related to, or ag- gravated by, the pregnancy or its management; and ‘‘(C) is not from an accidental or inci- dental cause; and ‘‘(3) the term ‘severe maternal morbidity’ means the unexpected outcomes of labor and deliv- ery that result in significant short- or long-term con- sequences to a woman’s health.’’.
SEC.

4.

REPORTING ON PREGNANCY-RELATED AND PREG- NANCY-ASSOCIATED DEATHS AND COMPLICA- TIONS.
(a) IN GENERAL.—The Secretary of Health and Human Services shall encourage each State to voluntarily submit to the Secretary each year a report containing the findings of a State maternal mortality review committee •S 3392 IS 10 with respect to each maternal death in the State that the committee reviewed during the year.
(b) MATERNAL AND INFANT HEALTH.—The Director of the Centers for Disease Control and Prevention shall— (1) update the Pregnancy Mortality Surveil- lance System or develop a separate system so that such system is capable of including data obtained from State maternal mortality review committees; and (2) provide technical assistance to States in re- viewing cases of pregnancy-related complications and pregnancy-associated complications.
(c) DEFINITIONS.—In this section, the terms ‘‘preg- nancy-associated complication’’ and ‘‘pregnancy-related complication’’ have the meanings given such terms in sec- tion 317K of the Public Health Service Act, as amended by section 3 •S 3392 IS