II 

116TH CONGRESS 

2D SESSION S. 4690 

To increase vaccination rates among pregnant women enrolled in Medicaid 

or CHIP, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 24, 2020 

Ms. HASSAN (for herself and Mr. CASSIDY) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

A BILL 

To increase vaccination rates among pregnant women 

enrolled in Medicaid or CHIP, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Maternal Immuniza5 tion Enhancement Act’’. 

6 SEC. 2. DEFINITIONS. 

7 In this Act: 

8 (1) CHIP.—The term ‘‘CHIP’’ means the chil9 dren’s health insurance program established under 

10 title XXI of the Social Security Act (42 U.S.C. 


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1 1397aa et seq.) and includes any waivers of such 

2 program. 

3 (2) MEDICAID.—The term ‘‘Medicaid’’ means 

4 the medical assistance program established under 

5 title XIX of the Social Security Act (42 U.S.C. 1396 

6 et seq.) and includes any waivers of such program. 

7 (3) SECRETARY.—The term ‘‘Secretary’’ means 

8 the Secretary of Health and Human Services. 

9 (4) STATE.—The term ‘‘State’’ has the mean10 ing given that term for purposes of title XIX of the 

11 Social Security Act (42 U.S.C. 1396 et seq.). 

12 SEC. 3. CMS GUIDANCE ON INCREASING VACCINATION 

13 RATES AMONG PREGNANT WOMEN EN14 ROLLED IN MEDICAID OR CHIP. 

15 (a) IN GENERAL.—Not later than 1 year after the 

16 date of enactment of this Act, the Administrator of the 

17 Centers for Medicare & Medicaid Services, in consultation 

18 with the Director of the Centers for Disease Control and 

19 Prevention, shall issue guidance to States on increasing 

20 the vaccination rates for Advisory Committee on Immuni21 zation Practices recommended vaccines among pregnant 

22 women enrolled in Medicaid or CHIP. 

23 (b) REQUIREMENTS.—The guidance issued under 

24 subsection (a) shall at a minimum include options and best 

25 practices for— 


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1 (1) increasing the vaccination rates for Advi2 sory Committee on Immunization Practices rec3 ommended vaccines among pregnant women, par4 ticularly with respect to the influenza, diphtheria, 

5 tetanus, and whooping cough (pertussis) vaccines; 

6 (2) billing and receiving Federal payments 

7 under Medicaid and CHIP for obtaining and admin8 istering such recommended vaccines to pregnant 

9 women; and 

10 (3) providing counseling and patient outreach 

11 and education regarding such vaccines. 

12 SEC. 4. INCLUSION OF PRENATAL IMMUNIZATION STATUS 

13 FOR PREGNANT WOMEN QUALITY MEASURE 

14 IN THE CORE SETS OF HEALTH CARE QUAL15 ITY MEASURES FOR CHILDREN ENROLLED IN 

16 MEDICAID OR CHIP AND ADULTS ENROLLED 

17 IN MEDICAID. 

18 (a) IN GENERAL.—Not later than 2 years after the 

19 date of enactment of this Act, the Secretary shall include 

20 a prenatal immunization status for pregnant women qual21 ity measure in— 

22 (1) the core set of child health quality measures 

23 for Medicaid and CHIP; and 

24 (2) the adult health care quality measures for 

25 Medicaid. 


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1 (b) REQUIREMENT.—The prenatal immunization sta2 tus for pregnant women quality measure included in such 

3 core sets of health quality measures shall measure the per4 centage of deliveries in which pregnant women received 

5 vaccines recommended by the Advisory Committee on Im6 munization Practices of the Centers for Disease Control 

7 and Prevention during pregnancy. 

8 SEC. 5. GAO REPORT. 

9 Not later than 2 years after the date of enactment 

10 of this Act, the Comptroller General of the United States 

11 shall submit a report to Congress on the vaccination rates 

12 among pregnant women enrolled in Medicaid or CHIP 

13 with respect to the Advisory Committee on Immunization 

14 Practices vaccines recommended for pregnant women. To 

15 the extent data are available, the report shall include the 

16 following: 

17 (1) The percentage of pregnant women enrolled 

18 in Medicaid or CHIP who did not receive vaccines 

19 paid for by Medicaid or CHIP as recommended by 

20 the Advisory Committee on Immunization Practices 

21 while pregnant. 

22 (2) To the extent practicable, an analysis of 

23 whether structural barriers, such as cost sharing or 

24 other specific requirements, are imposed under Med25 icaid or CHIP which impact the vaccination rates 


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1 among pregnant women enrolled in Medicaid or 

2 CHIP with respect to the Advisory Committee on 

3 Immunization Practices vaccines recommended for 

4 pregnant women. 

5 (3) To the extent practicable, an analysis of the 

6 reasons why women enrolled in Medicaid or CHIP 

7 do not receive such recommended vaccines rec8 ommended while pregnant. 

9 (4) To the extent practicable, demographic de10 tails regarding the population of pregnant women 

11 enrolled in Medicaid or CHIP, including race, eth12 nicity, and rural or urban geographic location. 

13 (5) As the Comptroller General deems appro14 priate, recommendations for legislative or adminis15 trative actions relating to increasing the vaccination 

16 rates among pregnant women enrolled in Medicaid 

17 or CHIP with respect to the Advisory Committee on 

18 Immunization Practices vaccines recommended for 

19 pregnant women. 

Æ 


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