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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5236 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  2d Session
                                S. 5236

   To amend titles XIX and XXI of the Social Security Act to enhance 
    financial support for rural and safety net hospitals providing 
maternity, labor, and delivery services to vulnerable populations, and 
                          for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                           September 25, 2024

  Mr. Wyden (for himself, Ms. Hassan, Ms. Stabenow, Ms. Cantwell, Mr. 
 Carper, Mr. Cardin, Mr. Brown, Mr. Bennet, Mr. Casey, Mr. Warner, Mr. 
Whitehouse, Ms. Cortez Masto, Ms. Warren, Mr. Helmy, Ms. Duckworth, Mr. 
 Booker, Mr. Merkley, and Mrs. Murray) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
   To amend titles XIX and XXI of the Social Security Act to enhance 
    financial support for rural and safety net hospitals providing 
maternity, labor, and delivery services to vulnerable populations, 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; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Keeping Obstetrics 
Local Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
TITLE I--ENHANCING FINANCIAL SUPPORT FOR RURAL AND SAFETY NET HOSPITALS 
                    THAT PROVIDE OBSTETRIC SERVICES

Sec. 101. State studies and HHS report on costs of providing maternity, 
                            labor, and delivery services.
Sec. 102. Requiring adequate payment rates under Medicaid for 
                            maternity, labor, and delivery services at 
                            eligible hospitals.
Sec. 103. Increased Federal financial participation for maternity, 
                            labor, and delivery services furnished by 
                            eligible hospitals.
Sec. 104. Labor and delivery services anchor payments.
Sec. 105. Application of adequate payment requirement and increased 
                            Federal financial participation 
                            requirements to CHIP.
Sec. 106. Disregarding increased and additional payments to hospitals 
                            for purposes of other supplemental payments 
                            and upper payment limits.
           TITLE II--EXPAND COVERAGE OF MATERNAL HEALTH CARE

Sec. 201. Requiring 12-month continuous, full benefit coverage for 
                            pregnant individuals under Medicaid and 
                            CHIP.
Sec. 202. Health homes for pregnant and postpartum women.
Sec. 203. Guidance on supporting and improving access to Medicaid and 
                            CHIP coverage of services provided by 
                            doulas and certain maternal health 
                            professionals.
Sec. 204. Medicaid and CHIP increased financial support for depression 
                            and anxiety screening during the perinatal 
                            and postpartum periods.
Sec. 205. Presumptive eligibility for pregnant individuals.
        TITLE III--INVEST IN THE MATERNAL HEALTH CARE WORKFORCE

Sec. 301. Emergency obstetric workforce support.
Sec. 302. Streamlined screening and enrollment of providers of 
                            maternity, labor, and delivery services in 
                            neighboring States.
 TITLE IV--REQUIRING PUBLIC COMMUNICATION OF OBSTETRICS DATA AND UNIT 
                                CLOSURES

Sec. 401. Timely notifications of impending hospital obstetric unit 
                            closures.
Sec. 402. Collection of data relating to hospital labor and delivery 
                            services.

TITLE I--ENHANCING FINANCIAL SUPPORT FOR RURAL AND SAFETY NET HOSPITALS 
                    THAT PROVIDE OBSTETRIC SERVICES

SEC. 101. STATE STUDIES AND HHS REPORT ON COSTS OF PROVIDING MATERNITY, 
              LABOR, AND DELIVERY SERVICES.

    (a) State Study.--
            (1) In general.--In order to meet the requirement of 
        section 1902(a)(6) of the Social Security Act (42 U.S.C. 
        1396a(a)(6)), not later than 1 year after the date of enactment 
        of this Act, and every 5 years thereafter, each State (as such 
        term is defined in section 1101(a)(1) of the Social Security 
        Act (42 U.S.C. 1301(a)(1)) for purposes of titles XIX and XXI 
        of such Act) shall conduct a study on the costs of providing 
        maternity, labor, and delivery services in hospitals and submit 
        the results of such study to the Secretary of Health and Human 
        Services (referred to in this section as the ``Secretary'').
            (2) Content of study.--A State study required under 
        paragraph (1) shall include the following information with 
        respect to maternity, labor, and delivery services furnished by 
        hospitals located in the State:
                    (A) An estimate of the cost of providing maternity, 
                labor, and delivery services at hospitals for which 
                more than 50 percent of births are financed by the 
                Medicaid program or the Children's Health Insurance 
                Program, based on the expenditures a representative 
                sample of such hospitals incurred for providing such 
                services during the 2 most recent years for which data 
                is available.
                    (B) An estimate of the full cost of providing 
                maternity, labor, and delivery services at independent 
                rural hospitals with less than 300 births per year, 
                based on the expenditures a representative sample of 
                such hospitals incurred for providing such services 
                during the 2 most recent years for which data are 
                available.
                    (C) An estimate of the cost of providing maternity 
                services at hospitals that ceased providing labor and 
                delivery services within the past 5 years, based on the 
                expenditures a representative sample of such hospitals 
                incurred for providing such services during the 2 most 
                recent years for which data is available.
                    (D) To the extent data allows, an analysis of the 
                extent to which factors such as geographic location and 
                community population affect the cost of providing 
                maternity, labor, and delivery services at hospitals, 
                including the cost of hospital services that support 
                the provision of maternity, labor, and delivery 
                services.
                    (E) The amounts hospitals are paid for maternity, 
                labor, and delivery services, by geographic location 
                and hospital size, under Medicare, the State Medicaid 
                program, the State CHIP plan, and private health 
                insurance, including, with respect to the State 
                Medicaid program, the State CHIP plan, and private 
                health insurance, payment amounts for such services 
                under fee-for-service payment arrangements and under 
                managed care (as applicable).
                    (F) A comparative payment rate analysis--
                            (i) comparing maternity, labor, and 
                        delivery services payment rates under the State 
                        Medicaid fee-for-service program to payment 
                        rates for such services under Medicare (as 
                        described in section 447.203(b)(3) of title 42, 
                        Code of Federal Regulations), other federally-
                        funded or State-funded programs (including, to 
                        the extent data is available, Medicaid managed 
                        care rates), and to the payment rates, to the 
                        extent data is available, of private health 
                        insurers within geographic areas of the State; 
                        and
                            (ii) analyzing different payment methods 
                        for such services, such as the use of bundled 
                        payments, quality incentives, and low-volume 
                        adjustments.
                    (G) An evaluation of whether each hospital located 
                in the State that furnishes maternity, labor, and 
                delivery services is expected to experience in the next 
                3 years--
                            (i) significant changes in particular 
                        expenditures or types of reimbursement for 
                        maternity, labor, and delivery services; or
                            (ii) any other significant change that is 
                        likely to affect the hospital's ability to 
                        continue to provide such services.
            (3) Assistance to small hospitals in compiling cost 
        information.--There is appropriated to the Secretary for each 
        fiscal year beginning with fiscal year 2025, $10,000,000 for 
        the purpose of providing grants and technical assistance to 
        small rural obstetric hospitals to enable such hospitals to 
        compile detailed information on expenses incurred for 
        maternity, labor, and delivery services for use in the State 
        studies required under paragraph (1), to remain available until 
        expended.
            (4) HHS report on state studies.--For each year in which 
        State studies are required to be conducted under paragraph (1), 
        the Secretary shall issue a public report that compiles and 
        details the results of such studies and includes the 
        information described in paragraph (2).
    (b) HHS Report and Proposed Legislation.--Not later than 2 years 
after the date of enactment of this Act, the Secretary shall submit to 
Congress and make publicly available a report analyzing the first 
studies conducted by States under subsection (a)(1) that includes--
            (1) recommendations for improving data collection on the 
        cost of providing maternity, labor, and delivery services;
            (2) guidance to States on the collection of such data; and
            (3) if the Secretary determines it appropriate based on the 
        findings made by the Secretary in such report, proposed 
        legislation or administrative action, including, to the extent 
        the Secretary determines appropriate, issuance of regulations, 
        to adjust the amounts paid for maternity, labor, and delivery 
        services under Medicare, State Medicaid plans, and other 
        federally-funded payers, to more accurately compensate eligible 
        hospitals (as such term is defined in subsection (uu) of 
        section 1902 of the Social Security Act (42 U.S.C. 1396a), as 
        added by section 102) for the cost of providing such services.

SEC. 102. REQUIRING ADEQUATE PAYMENT RATES UNDER MEDICAID FOR 
              MATERNITY, LABOR, AND DELIVERY SERVICES AT ELIGIBLE 
              HOSPITALS.

    (a) Fee-for-Service Payments.--Section 1902 of the Social Security 
Act (42 U.S.C. 1396a) is amended--
            (1) in subsection (a)(13)--
                    (A) by striking ``and'' at the end of subparagraph 
                (B);
                    (B) by adding ``and'' at the end of subparagraph 
                (C); and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(D) for each fiscal year beginning with fiscal 
                year 2026, payment for maternity, labor, and delivery 
                services (as defined in subsection (uu)) furnished 
                during such fiscal year in an eligible hospital (as 
                defined in such subsection) at a rate that is not less 
                than the minimum payment rate specified for the fiscal 
                year in paragraph (4) of such subsection;''; and
            (2) by adding at the end the following new subsection:
    ``(uu) Maternity, Labor, and Delivery Services and Eligible 
Hospitals Defined.--For purposes of subsection (a)(13)(D)--
            ``(1) Maternity, labor, and delivery services.--
                    ``(A) In general.--The term `maternity, labor, and 
                delivery services' means such inpatient hospital 
                services and outpatient hospital services, including 
                behavioral health services, that are provided in 
                relation to maternity care or labor and delivery, 
                identified by appropriate ICD and CPT codes, as the 
                Secretary shall specify after consultation with 
                professional or medical societies with expertise in 
                pregnancy, childbirth, and postpartum care.
                    ``(B) Scope.--Such term shall not be limited in 
                application, for any eligible hospital, only to 
                services that relate to a birth that occurs in the 
                hospital.
                    ``(C) Rulemaking.--Not later than July 1, 2025, the 
                Secretary shall issue an interim final rule specifying 
                which services shall be considered maternity, labor, 
                and delivery services for purposes of this subsection 
                and subsection (a)(13)(D).
            ``(2) Eligible hospital.--
                    ``(A) In general.--The term `eligible hospital' 
                means, with respect to a State and fiscal year--
                            ``(i) a hospital that is located in a rural 
                        area (as defined by the Federal Office of Rural 
                        Health Policy for the purpose of rural health 
                        grant programs administered by such Office);
                            ``(ii) a critical access hospital (as 
                        defined in section 1861(mm)(1));
                            ``(iii) a hospital operated by the Indian 
                        Health Service or an Indian Tribe under the 
                        Indian Self-Determination and Education 
                        Assistance Act;
                            ``(iv) a hospital for which, in the most 
                        recent 12-month period for which data is 
                        available, at least 50 percent of all births 
                        for which the hospital provided maternity, 
                        labor, and delivery services during such fiscal 
                        year were qualifying births; or
                            ``(v) a hospital that is able to 
                        demonstrate, through a process to be determined 
                        by the Secretary, that, for the applicable 
                        fiscal year, the hospital projects that at 
                        least 50 percent of all births for which the 
                        hospital will provide maternity, labor, and 
                        delivery services during such fiscal year will 
                        be qualifying births.
                    ``(B) Identification of eligible hospitals.--Each 
                State, subject to the approval of the Secretary, shall 
                identify the hospitals in the State that are eligible 
                hospitals with respect to a fiscal year.
            ``(3) Qualifying birth.--For purposes of paragraph (2), the 
        term `qualifying birth' means a birth for which any maternity, 
        labor, and delivery services associated with the birth--
                    ``(A) were paid for under a State plan under this 
                title (or under a waiver of such a plan) or under a 
                State child health plan under title XXI (or under a 
                waiver of such a plan);
                    ``(B) were paid for under title XVIII;
                    ``(C) were provided by the Indian Health Service or 
                a Native Hawaiian health care system (as defined in 
                section 12 of the Native Hawaiian Health Care 
                Improvement Act); or
                    ``(D) were provided to a patient who does not have 
                minimum essential coverage (as defined in section 
                5000A(f) of the Internal Revenue Code of 1986) and were 
                not fully paid for by such patient.
            ``(4) Minimum payment rate specified.--The minimum payment 
        rate specified in this paragraph is, with respect to an 
        eligible hospital and maternal, labor, and delivery services--
                    ``(A) for fiscal year 2026, 150 percent of the 
                payment rate that would apply for such services and 
                hospital under title XVIII; and
                    ``(B) for each period of 5 fiscal years beginning 
                with fiscal years 2027 through 2031, a payment rate 
                that is determined for such period by the Secretary to 
                accurately reflect the costs incurred by eligible 
                hospitals in providing such services, informed by the 
                results of the most recent State studies submitted to 
                the Secretary under section 101(a) of the Keeping 
                Obstetrics Local Act.''.
    (b) Under Medicaid Managed Care Plans.--Section 1932(f) of the 
Social Security Act (42 U.S.C. 1396u-2(f)) is amended--
            (1) in the heading, by inserting ``and Maternity, Labor, 
        and Delivery Services at Eligible Hospitals'' after 
        ``Services''; and
            (2) by striking ``described in section 1902(a)(13)(C)'' and 
        inserting ``described in subparagraph (C) of section 
        1902(a)(13) or maternity, labor, and delivery services 
        described in subparagraph (D) of such section that are 
        furnished by an eligible hospital (as defined in section 
        1905(uu))''.

SEC. 103. INCREASED FEDERAL FINANCIAL PARTICIPATION FOR MATERNITY, 
              LABOR, AND DELIVERY SERVICES FURNISHED BY ELIGIBLE 
              HOSPITALS.

    Section 1905 of the Social Security Act (42 U.S.C. 1396d) is 
amended--
            (1) in subsection (b), by striking ``and (ii)'' and 
        inserting ``(ii), and (kk)''; and
            (2) by adding at the end the following new subsection:
    ``(kk) Maternity, Labor, and Delivery Services.--
            ``(1) In general.--Notwithstanding subsection (b), with 
        respect to State expenditures for medical assistance for 
        maternity, labor, and delivery services furnished by an 
        eligible hospital (as such terms are defined in section 
        1902(uu)) in a fiscal quarter that begins on or after October 
        1, 2025--
                    ``(A) the Federal medical assistance percentage 
                applicable to the enhanced payment rate amount of such 
                expenditures (as determined for the State and quarter 
                under paragraph (2)(A)) shall be equal to 100 percent; 
                and
                    ``(B) subject to paragraph (3), the Federal medical 
                assistance percentage applicable to the base payment 
                rate amount of such expenditures (as determined for the 
                State and quarter under paragraph (2)(B)) shall be 
                equal to the enhanced FMAP determined for the State and 
                quarter under section 2105(b).
            ``(2) Determination of enhanced payment rate amount and 
        base payment rate amount.--
                    ``(A) Enhanced payment rate amount.--
                            ``(i) In general.--For purposes of 
                        paragraph (1)(A), the enhanced payment rate 
                        amount for a State and fiscal quarter is equal 
                        to the amount of State expenditures for medical 
                        assistance for maternity, labor, and delivery 
                        services furnished by an eligible hospital (as 
                        such terms are defined in section 1902(uu)) in 
                        such fiscal quarter that is attributable to the 
                        amount by which the minimum payment rate 
                        required under section 1902(a)(13)(D) (or, by 
                        application, section 1932(f)) exceeds the base 
                        payment rate applicable to such services, as 
                        determined for the State, quarter, and services 
                        under clause (ii).
                            ``(ii) Base payment rate.--For purposes of 
                        clause (i), the base payment rate determined 
                        for a State, a fiscal quarter, and maternity, 
                        labor, and delivery services (as defined in 
                        section 1902(uu)) shall be equal to--
                                    ``(I) the payment rate applicable 
                                to such services under the State plan 
                                (or under a waiver of such plan) as of 
                                January 1, 2024; increased by
                                    ``(II) the percentage increase in 
                                the medical care component of the 
                                consumer price index for all urban 
                                consumers from January of 2024 to the 
                                month ending on the day before the 1st 
                                day of such fiscal quarter.
                    ``(B) Base payment rate amount.--For purposes of 
                paragraph (1)(B), the base payment rate amount for a 
                State and fiscal quarter is equal to--
                            ``(i) the total amount of State 
                        expenditures for medical assistance for 
                        maternity, labor, and delivery services 
                        furnished by an eligible hospital (as such 
                        terms are defined in section 1902(uu)) in such 
                        fiscal quarter; minus
                            ``(ii) the enhanced payment rate amount 
                        determined for the State and fiscal quarter 
                        under subparagraph (A).
            ``(3) Application of higher match.--Subparagraph (B) of 
        paragraph (1) shall not apply in the case of State expenditures 
        described in such subparagraph if the application of such 
        subparagraph would result in a lower Federal medical assistance 
        percentage for such expenditures than would otherwise apply 
        without the application of such paragraph.
            ``(4) Exclusion of expenditures from territorial caps.--Any 
        payment made to a territory for medical assistance that is 
        subject to the Federal medical assistance percentage specified 
        in paragraph (1)(A) or the enhanced FMAP referred to in 
        paragraph (1)(B) shall not be taken into account for purposes 
        of applying payment limits under subsections (f) and (g) of 
        section 1108.''.

SEC. 104. LABOR AND DELIVERY SERVICES ANCHOR PAYMENTS.

    (a) State Requirement.--Section 1902(a)(13)(A) of the Social 
Security Act (42 U.S.C. 1396a(a)(13)(A)) is amended--
            (1) in clause (iii), by striking ``and'' at the end;
            (2) in clause (iv), by striking the semicolon at the end 
        and inserting ``, and''; and
            (3) by adding at the end the following new clause:
                            ``(v) in the case of hospitals, such rates 
                        take into account (in a manner consistent with 
                        section 1923A) the situation of low volume 
                        obstetric hospitals (as such term is defined in 
                        such section);''.
    (b) Requiring Anchor Payments for Low Volume Obstetric Hospitals.--
Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is 
amended by inserting the following after section 1923:

``SEC. 1923A. ANCHOR PAYMENTS FOR LABOR AND DELIVERY SERVICES PROVIDED 
              BY LOW VOLUME OBSTETRIC HOSPITALS.

    ``(a) Implementation of Requirement.--A State plan under this title 
shall not be considered to meet the requirement of section 
1902(a)(13)(A)(v) (insofar as it requires payments to hospitals to take 
into account the situation of low volume obstetric hospitals), as of 
October 1, 2025, unless the State has submitted to the Secretary, by 
not later than such date, an amendment to such plan that provides for 
an annual anchor payment to such hospitals, consistent with subsection 
(c).
    ``(b) Definitions.--In this section:
            ``(1) Antenatal transfer.--The term `antenatal transfer' 
        means, with respect to a hospital, a pregnant individual who 
        was expected to receive labor and delivery services at the 
        hospital but who is transferred to a different hospital because 
        of a need for labor and delivery services that are not 
        available at the transferring hospital.
            ``(2) Delivery volume.--The term `delivery volume' means, 
        with respect to a hospital and a fiscal year, the total number 
        of births occurring in, and antenatal transfers made by, such 
        hospital during such year.
            ``(3) Labor and delivery revenue floor.--The term `labor 
        and delivery revenue floor' means, with respect to a low volume 
        obstetric hospital and a fiscal year, the amount equal to the 
        sum of--
                    ``(A) the product of--
                            ``(i) the delivery volume for such hospital 
                        and fiscal year; and
                            ``(ii) the per delivery amount for such 
                        fiscal year; and
                    ``(B) the standby capacity amount for such fiscal 
                year.
            ``(4) Labor and delivery services.--The term `labor and 
        delivery services' means such inpatient and outpatient hospital 
        services related to labor and delivery, including services 
        related to antenatal transfers, identified by appropriate ICD 
        and CPT codes, as the Secretary shall specify in consultation 
        with professional or medical societies with expertise in this 
        area.
            ``(5) Low volume obstetric hospital.--The term `low volume 
        obstetric hospital' means, with respect to a hospital and a 
        fiscal year, a hospital--
                    ``(A) that is an eligible hospital (as defined in 
                section 1902(uu)(2));
                    ``(B) in which the average number of births for 
                which the hospital provided labor and delivery services 
                during the preceding 3 fiscal years is less than 300 
                births per year;
                    ``(C) that did not provide labor and delivery 
                services in the preceding fiscal year, but in which the 
                average number of births for which the hospital 
                provided labor and delivery services during the most 
                recent 3 fiscal years in which the hospital provided 
                labor and delivery services is less than 300 births per 
                year;
                    ``(D) that is not described in subparagraph (B) or 
                (C) but, in the applicable fiscal year, provides labor 
                and delivery services for fewer than 300 births; or
                    ``(E) that is not described in subparagraphs (B) 
                through (D) but is certified by the State in which the 
                hospital is located as meeting such criteria as the 
                Secretary shall establish for identifying hospitals 
                that are essential to meeting the needs of an 
                underserved population, such as serving a population 
                with limited English proficiency, serving specific 
                racial or ethnic populations, or other factors.
            ``(6) Medicaid labor and delivery revenue floor.--The term 
        `Medicaid labor and delivery revenue floor' means, with respect 
        to a low volume obstetric hospital and a fiscal year, the 
        product of--
                    ``(A) the labor and delivery revenue floor for such 
                hospital and fiscal year; and
                    ``(B) the percentage of the delivery volume of such 
                hospital in such fiscal year that were paid for under a 
                State plan under this title (or under a waiver of such 
                a plan) or under a State child health plan under title 
                XXI (or under a waiver of such a plan).
            ``(7) Per delivery amount.--
                    ``(A) In general.--The term `per delivery amount' 
                means, with respect to a fiscal year, an amount, as 
                determined under subparagraph (B), that represents the 
                marginal cost to a low volume obstetric hospital of a 
                birth or an antenatal transfer.
                    ``(B) Determination of per delivery amount.--
                            ``(i) Fiscal year 2027.--For fiscal year 
                        2027, the per delivery amount shall be $10,000.
                            ``(ii) Indexing.--Subject to clause (iii), 
                        for each fiscal year after fiscal year 2027, 
                        the per delivery amount shall be the amount 
                        that applied under this subparagraph for the 
                        preceding fiscal year increased by the 
                        percentage increase in the medical care 
                        component of the consumer price index for all 
                        urban consumers for the 12-month period ending 
                        with September of such preceding fiscal year.
                            ``(iii) Periodic revision of per delivery 
                        amount.--Not less than once every 5 fiscal 
                        years, the Secretary shall collect and analyze 
                        data on the costs of labor and delivery 
                        services at low volume obstetric hospitals and, 
                        through rulemaking, shall establish a new per 
                        delivery amount for purposes of this section to 
                        ensure that such amount accurately reflects the 
                        marginal cost to a low volume obstetric 
                        hospital of a birth or an antenatal delivery.
            ``(8) Standby capacity amount.--
                    ``(A) In general.--The term `standby capacity 
                amount' means, with respect to a fiscal year, an 
                amount, as determined under subparagraph (B), that 
                represents the minimum level of expenditures by a low 
                volume obstetric hospital that is necessary to ensure 
                that adequate personnel, equipment, and facilities are 
                available at all times to provide labor and delivery 
                services.
                    ``(B) Determination of standby capacity amount.--
                            ``(i) Fiscal year 2027.--For fiscal year 
                        2027, the standby capacity amount shall be 
                        $1,200,000.
                            ``(ii) Indexing.--Subject to clause (iii), 
                        for each fiscal year after fiscal year 2027, 
                        the standby capacity amount shall be the amount 
                        that applied under this subparagraph for the 
                        preceding fiscal year increased by the 
                        percentage increase in the medical care 
                        component of the consumer price index for all 
                        urban consumers for the 12-month period ending 
                        with September of such preceding fiscal year.
                            ``(iii) Periodic revision of standby 
                        capacity amount.--Not less than once every 5 
                        fiscal years, the Secretary shall collect and 
                        analyze data on the costs of labor and delivery 
                        services at low volume obstetric hospitals and, 
                        through rulemaking, shall establish a new 
                        standby capacity amount for purposes of this 
                        section to ensure that such amount accurately 
                        reflects the minimum level of expenditures by a 
                        low volume obstetric hospital that is necessary 
                        to ensure that adequate personnel, equipment, 
                        and facilities are available at all times to 
                        provide labor and delivery services.
    ``(c) Anchor Payment for Low Volume Obstetric Hospitals.--Not later 
than 3 months after the end of each fiscal year beginning with fiscal 
year 2027, each State shall pay to each low volume obstetric hospital 
in the State an amount that is equal to the amount (if any) by which--
            ``(1) the Medicaid labor and delivery revenue floor for the 
        hospital and fiscal year; exceeds
            ``(2) the total amount of all payments made to the low 
        volume obstetric hospital under the State plan under this title 
        (or under a waiver of such plan) and under the State child 
        health plan under title XXI (or under a waiver of such plan) 
        (other than payments under this section) for labor and delivery 
        services provided by such hospital during such fiscal year.
    ``(d) Requirements for Receipt of Payments.--No anchor payment 
shall be made to a low volume obstetric hospital under this section for 
a fiscal year unless the hospital can satisfy the following 
requirements:
            ``(1) Skills maintenance and training activities.--The 
        hospital demonstrates to the satisfaction of the State that the 
        hospital conducts and completes skills maintenance and training 
        activities, including continuing education and training to 
        support maintenance of obstetric skills, that satisfy such 
        requirements as the Secretary, taking into consideration 
        nationally recognized obstetrics skills, maintenance, and 
        training standards such as standards published by the American 
        College of Obstetricians and Gynecologists and the Association 
        of Women's Health, Obstetric, and Neonatal Nurses, shall 
        specify for the purposes of this section.
            ``(2) Continued provision of labor and delivery services.--
                    ``(A) In general.--The hospital and the State enter 
                into a contract under which, in exchange for such 
                payment under this section for a fiscal year, the 
                hospital agrees to continue to provide labor and 
                delivery services--
                            ``(i) for the period that begins with such 
                        fiscal year and ends on the last day of the 
                        second fiscal year that follows such fiscal 
                        year; and
                            ``(ii) at a level that is not less than the 
                        level at which the hospital provided such 
                        services in the fiscal year to which such 
                        payment relates, unless the hospital can 
                        demonstrate that the need for services in the 
                        community has decreased and that the new level 
                        of services will be adequate to meet that need.
                    ``(B) Recovery of payment in the event of breach of 
                contract by hospital.--The terms of the contract 
                between a hospital and a State required under 
                subparagraph (A) shall provide that if the hospital 
                does not provide labor and delivery services as 
                required under the contract throughout the period 
                described in such subparagraph for any reason 
                (including in the event of the hospital's bankruptcy or 
                closure) the State may recover the full amount of the 
                payment under this section to which the contract 
                relates and in the event of the hospital's bankruptcy, 
                the State shall be given preferred creditor status for 
                purposes of the collection of such payment.
            ``(3) Utilization of funds for labor and delivery 
        services.--
                    ``(A) In general.--The hospital and the State enter 
                into a contract under which, in exchange for such 
                payment under this section, the hospital agrees to 
                utilize funds received under such payment for the 
                provision of labor and delivery services in the 
                community served by the hospital.
                    ``(B) Recovery of payment in the event of breach of 
                contract by hospital.--The terms of the contract 
                between a hospital and a State required under 
                subparagraph (A) shall provide that if the hospital 
                does not utilize payment funds for labor and delivery 
                services as required under the contract for any reason 
                (including in the event of the hospital's bankruptcy or 
                closure) the State may recover the full amount of the 
                payment under this section to which the contract 
                relates and in the event of the hospital's bankruptcy, 
                the State shall be given preferred creditor status for 
                purposes of the collection of such payment.
    ``(e) Treatment of Payments; Recovery of Payments.--
            ``(1) In general.--Payments made by a State under this 
        section for a fiscal year--
                    ``(A) shall be in addition to any other payments 
                made to hospitals for labor and delivery services under 
                the State plan (or a waiver of such plan) under this 
                title, under the State child health assistance plan 
                under title XXI (or under a waiver of such plan), or 
                under title XVIII for the fiscal year, including 
                disproportionate share hospital payments under section 
                1923 or section 1886(d)(5)(F) and other supplemental 
                payments that are not made under this section; and
                    ``(B) shall be treated as medical assistance for 
                which payment is made under section 1903(a), except 
                that the Federal medical assistance percentage 
                applicable to amounts expended by a State for such 
                payments shall be equal to the enhanced FMAP determined 
                for the State and fiscal year under section 2105(b).
            ``(2) Payments recovered by a state.--If a State recovers 
        any amount of a payment made by a State under this section 
        (whether pursuant to paragraph (2)(B) or (3)(B) of subsection 
        (d) or otherwise), the amount so recovered shall be treated as 
        an overpayment recovered by the State under section 1903(d).''.
    (c) Conforming Amendments.--Title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) is amended as follows:
            (1) In section 1903--
                    (A) in subsection (d)(6)(B)--
                            (i) by striking ``related to the total 
                        amount'' and inserting the following: ``related 
                        to--
                    ``(i) the total amount'';
                            (ii) by striking the period at the end and 
                        inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new clause:
                    ``(ii) the total amount of payments made to 
                individual providers (by provider) under section 1923A 
                during such fiscal year.''; and
                    (B) in subsection (bb)(2)(B)--
                            (i) in the header, by inserting ``and low 
                        volume obstetric hospital'' after ``DSH''; and
                            (ii) by inserting ``or a payment made to a 
                        low volume obstetric hospital under section 
                        1923A'' before the period.
            (2) In section 1905--
                    (A) in subsection (cc), by striking ``section 
                1923'' the second place it appears and inserting 
                ``section 1923 or 1923A''; and
                    (B) in subsection (ii)(2)(A), by inserting ``or 
                payments to low volume obstetric hospitals described in 
                section 1923A'' before the semicolon.

SEC. 105. APPLICATION OF ADEQUATE PAYMENT REQUIREMENT AND INCREASED 
              FEDERAL FINANCIAL PARTICIPATION REQUIREMENTS TO CHIP.

    Section 2107(e)(1) of the Social Security Act (42 U.S.C. 
1397gg(e)(1)) is amended--
            (1) by redesignating subparagraphs (B) through (U) as 
        subparagraphs (C) through (V), respectively; and
            (2) by inserting after subparagraph (A) the following new 
        subparagraph:
                    ``(B) Section 1902(a)(13)(D) and section 1905(kk) 
                (relating to the minimum payment rate required for 
                maternity, labor, and delivery services furnished by an 
                eligible hospital and Federal financial participation 
                for State expenditures for such services).''.

SEC. 106. DISREGARDING INCREASED AND ADDITIONAL PAYMENTS TO HOSPITALS 
              FOR PURPOSES OF OTHER SUPPLEMENTAL PAYMENTS AND UPPER 
              PAYMENT LIMITS.

    A hospital's eligibility for any federally-funded supplemental 
payment (including a disproportionate share payment under section 
1886(d)(5)(F) or 1923 of the Social Security Act (42 U.S.C. 
1395ww(d)(5)(F), 1396r-4)), the determination of the amount of such 
payment, and the application of any Federal limitation on the aggregate 
amount of payments that a State may make to the hospital (including any 
upper payment limitation), shall be determined without regard to the 
amount of any increase to a payment received by a hospital or any 
additional payment made to a hospital that is attributable to the 
amendments made by this title.

           TITLE II--EXPAND COVERAGE OF MATERNAL HEALTH CARE

SEC. 201. REQUIRING 12-MONTH CONTINUOUS, FULL BENEFIT COVERAGE FOR 
              PREGNANT INDIVIDUALS UNDER MEDICAID AND CHIP.

    (a) Medicaid.--Section 1902 of the Social Security Act (42 U.S.C. 
1396a) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (10), in the matter following 
                subparagraph (G), by striking ``(VII) the medical 
                assistance made available to an individual described in 
                subsection (l)(1)(A) who is eligible for medical 
                assistance only because of subparagraph (A)(i)(IV) or 
                (A)(ii)(IX) shall be limited to medical assistance for 
                services related to pregnancy (including prenatal, 
                delivery, postpartum, and family planning services), 
                medical assistance for services related to other 
                conditions which may complicate pregnancy, and medical 
                assistance for vaccines described in section 
                1905(a)(4)(E) and the administration of such vaccines 
                during the period described in such section,'' and 
                inserting ``(VII) [Repealed],'';
                    (B) in paragraph (86), by striking ``and'' at the 
                end;
                    (C) in paragraph (87), by striking the period at 
                the end and inserting ``; and''; and
                    (D) by inserting after paragraph (87) the following 
                new paragraph:
            ``(88) provide that the State plan is in compliance with 
        subsection (e)(16).''; and
            (2) in subsection (e)(16)--
                    (A) in subparagraph (A), by striking ``At the 
                option of the State, the State plan (or waiver of such 
                State plan) may provide'' and inserting ``A State plan 
                (or waiver of such State plan) shall provide'';
                    (B) in subparagraph (B), in the matter preceding 
                clause (i), by striking ``by a State making an election 
                under this paragraph'' and inserting ``under a State 
                plan (or a waiver of such State plan)''; and
                    (C) in subparagraph (C)--
                            (i) by striking ``A State making an 
                        election under this paragraph'' and inserting 
                        ``In the case of a State''; and
                            (ii) by striking ``shall also make the 
                        election'' and inserting ``the State shall 
                        provide coverage''.
    (b) CHIP.--
            (1) In general.--Subparagraph (K) of section 2107(e)(1) of 
        the Social Security Act (42 U.S.C. 1397gg(e)(1)), as 
        redesignated by section 105, is amended to read as follows:
                    ``(K) Paragraphs (5) and (16) of section 1902(e) 
                (relating to the requirement to provide medical 
                assistance under the State plan or waiver consisting of 
                full benefits during pregnancy and throughout the 12-
                month period that begins on the last day of the 
                individual's pregnancy and ends on the last day of the 
                month in which such 12-month period ends).''.
            (2) Conforming amendment.--Section 2112(d)(2)(A) of the 
        Social Security Act (42 U.S.C. 1397ll(d)(2)(A)) is amended by 
        striking ``the month in which the 60-day period'' and all that 
        follows through ``pursuant to section 2107(e)(1),''.
    (c) Effective Date.--
            (1) In general.--Subject to paragraphs (2) and (3), the 
        amendments made by subsections (a) and (b) shall take effect on 
        the 1st day of the 1st calendar quarter that begins on or after 
        the date that is 1 year after the date of enactment of this 
        Act;
            (2) Exception for state legislation.--In the case of a 
        State plan under title XIX of the Social Security Act or a 
        State child health plan under title XXI of such Act that the 
        Secretary of Health and Human Services determines requires 
        State legislation in order for the respective plan to meet any 
        requirement imposed by amendments made by this subsection, the 
        respective plan shall not be regarded as failing to comply with 
        the requirements of such title solely on the basis of its 
        failure to meet such an additional requirement before the 1st 
        day of the 1st calendar quarter beginning after the close of 
        the 1st regular session of the State legislature that begins 
        after the date of enactment of this Act. For purposes of the 
        previous sentence, in the case of a State that has a 2-year 
        legislative session, each year of the session shall be 
        considered to be a separate regular session of the State 
        legislature.
            (3) State option for earlier effective date.--A State may 
        elect to have subsection (e)(16) of section 1902 of the Social 
        Security Act (42 U.S.C. 1396a) and subparagraph (K) of section 
        2107(e)(1) of the Social Security Act (42 U.S.C. 1397gg(e)(1)), 
        as redesignated by section 105 and amended by subsection (b) of 
        this section, take effect with respect to the State on the 1st 
        day of any fiscal quarter that begins before the date described 
        in paragraph (1) and apply to amounts payable to the State for 
        expenditures for medical assistance, child health assistance, 
        or pregnancy-related assistance to pregnant or postpartum 
        individuals furnished on or after such day.

SEC. 202. HEALTH HOMES FOR PREGNANT AND POSTPARTUM WOMEN.

    (a) Medicaid.--Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended by inserting after section 1945A the following new 
section:

``SEC. 1945B. STATE OPTION TO PROVIDE COORDINATED CARE THROUGH A HEALTH 
              HOME FOR PREGNANT AND POSTPARTUM INDIVIDUALS.

    ``(a) State Option.--
            ``(1) In general.--Notwithstanding section 1902(a)(1) 
        (relating to statewideness) and section 1902(a)(10)(B) 
        (relating to comparability), beginning January 1, 2028, a 
        State, at its option as a State plan amendment, may provide for 
        medical assistance under this title to an eligible individual 
        who chooses to--
                    ``(A) enroll in a maternity health home under this 
                section by selecting a designated provider, a team of 
                health care professionals operating with such a 
                provider, or a health team as the individual's 
                maternity health home for purposes of providing the 
                individual with pregnancy and postpartum coordinated 
                care services; or
                    ``(B) receive such services from a designated 
                provider, a team of health care professionals operating 
                with such a provider, or a health team that has 
                voluntarily opted to participate in a maternity health 
                home for eligible individuals under this section.
            ``(2) Eligible individual defined.--In this section, the 
        term `eligible individual' means an individual--
                    ``(A) who is eligible for medical assistance under 
                the State plan (or under a waiver of such plan) for all 
                items and services covered under the State plan (or 
                under a waiver of such plan);
                    ``(B) who is not enrolled in a health home under 
                section 1945 or 1945A; and
                    ``(C) either--
                            ``(i) who is pregnant; or
                            ``(ii) whose pregnancy has ended and is 
                        within the 12-month period that begins on the 
                        last day of the individual's pregnancy and ends 
                        on the last day of the month in which such 12-
                        month period ends.
    ``(b) Qualification Standards.--The Secretary shall establish 
standards for qualification as a maternity health home or as a 
designated provider, a team of health care professionals operating with 
such a provider, or a health team eligible for participation in a 
maternity health home for purposes of this section. In establishing 
such standards, the Secretary shall consider best practices and models 
of care used by recipients of grants under section 330P of the Public 
Health Service Act. Such standards shall include requiring a designated 
provider, a team of health care professionals operating with such a 
provider, and a health team designated as a maternity health home to 
demonstrate to the State the ability to do the following:
            ``(1) Coordinate prompt care and access to necessary 
        maternity care services, including services provided by 
        specialists, and programs for an eligible individual during the 
        individual's pregnancy and the 365-day period beginning on the 
        last day of such pregnancy.
            ``(2) Develop an individualized, comprehensive, patient-
        centered care plan for each eligible individual that 
        accommodates patient preferences and, if applicable, reflects 
        adjustments to the payment methodology described in subsection 
        (c)(2)(B).
            ``(3) Develop and incorporate into each eligible 
        individual's care plan, in a culturally and linguistically 
        appropriate manner consistent with the needs of the eligible 
        individual, ongoing home care, community-based primary care, 
        inpatient care, social support services, health-related social 
        needs services, behavioral health services, local hospital 
        emergency care, and, in the event of a change in income that 
        would result in the eligible individual losing eligibility for 
        medical assistance under the State plan (or under a waiver of 
        such plan), care management and planning related to a change in 
        the eligible individual's health insurance coverage.
            ``(4) Coordinate with pediatric care providers, as 
        appropriate.
            ``(5) Collect and report information under subsection 
        (f)(1).
    ``(c) Payments.--
            ``(1) In general.--A State shall provide a designated 
        provider, a team of health care professionals operating with 
        such a provider, or a health team designated as a maternity 
        health home with payments for the provision of health home 
        services to each eligible individual that selects such 
        provider, team of health care professionals, or health team as 
        the eligible individual's health home. Payments made to a 
        designated provider, a team of health care professionals 
        operating with such a provider, or a health team for such 
        services shall be treated as medical assistance for purposes of 
        section 1903(a), except that, during the first 8 fiscal year 
        quarters that the State plan amendment is in effect, the 
        Federal medical assistance percentage applicable to such 
        payments shall be equal to 90 percent.
            ``(2) Methodology.--The State shall specify in the State 
        plan amendment the methodology the State will use for 
        determining payment for the provision of pregnancy and 
        postpartum coordinated care services or treatment during an 
        eligible individual's pregnancy and the 365-day period 
        beginning on the last day of such pregnancy. Such methodology 
        for determining payment--
                    ``(A) may be based on--
                            ``(i) a per-member per-month basis for each 
                        eligible individual enrolled in a maternity 
                        health home;
                            ``(ii) a prospective payment model, in the 
                        case of payments to Federally qualified health 
                        centers or a rural health clinics; or
                            ``(iii) an alternate model of payment 
                        proposed by the State and approved by the 
                        Secretary;
                    ``(B) may be adjusted to reflect, with respect to 
                each eligible individual--
                            ``(i) the severity of the risks associated 
                        with the individual's pregnancy;
                            ``(ii) the severity of the risks associated 
                        with the individual's postpartum health care 
                        needs; and
                            ``(iii) the level or amount of time of care 
                        coordination required with respect to the 
                        individual; and
                    ``(C) shall be established consistent with section 
                1902(a)(30)(A).
    ``(d) Coordinating Care.--
            ``(1) Hospital notification.--A State with a State plan 
        amendment approved under this section shall require each 
        hospital that is a participating provider under the State plan 
        (or under a waiver of such plan) to establish procedures in the 
        case of an eligible individual who seeks treatment in the 
        emergency department of such hospital for--
                    ``(A) providing the individual with culturally and 
                linguistically appropriate information supplied by the 
                State describing the respective treatment models and 
                opportunities for the individual to access a maternity 
                health home and its associated benefits; and
                    ``(B) notifying the maternity health home in which 
                the individual is enrolled, or the designated provider, 
                team of health care professionals operating with such a 
                provider, or health team treating the individual, of 
                the individual's treatment in the emergency department 
                and of the protocols for the maternity health home, 
                designated provider, or team to be involved in the 
                individual's emergency care or post-discharge care.
            ``(2) Education with respect to availability of a maternity 
        health home.--
                    ``(A) In general.--In order for a State plan 
                amendment to be approved under this section, a State 
                shall include in the State plan amendment a description 
                of the State's process for--
                            ``(i) educating providers participating in 
                        the State plan (or a waiver of such plan) on 
                        the availability of maternity health homes for 
                        eligible individuals, including the process by 
                        which such providers can participate in or 
                        refer an eligible individual to an approved 
                        maternity health home or a designated provider, 
                        team of health care professionals operating 
                        such a provider, or health team designated as a 
                        maternity health home; and
                            ``(ii) educating eligible individuals, in a 
                        culturally and linguistically appropriate 
                        manner, on the availability of maternity health 
                        homes.
                    ``(B) Outreach.--The process established by the 
                State under subparagraph (A) shall include the 
                participation of entities or other public or private 
                organizations or entities that provide outreach and 
                information on the availability of health care items 
                and services to families of individuals eligible to 
                receive medical assistance under the State plan (or a 
                waiver of such plan).
            ``(3) Mental health coordination.--A State with a State 
        plan amendment approved under this section shall consult and 
        coordinate, as appropriate, with the Secretary in addressing 
        issues regarding the prevention, identification, and treatment 
        of mental health conditions and substance use disorders among 
        eligible individuals.
            ``(4) Social and support services.--A State with a State 
        plan amendment approved under this section shall consult and 
        coordinate, as appropriate, with the Secretary in establishing 
        means to connect eligible individuals receiving pregnancy and 
        postpartum coordinated care services under this section with 
        social and support services, including services made available 
        under maternal, infant, and early childhood home visiting 
        programs established under section 511 and services made 
        available under section 330H or title X of the Public Health 
        Service Act.
            ``(5) Coordination with grant program for integrated 
        services for pregnant and postpartum women.--A State with a 
        State plan amendment approved under this section shall consult 
        and coordinate, as appropriate, with the Secretary with respect 
        to the provision of medical assistance to eligible individuals 
        enrolled in a maternity health home under this section and 
        grantees delivering integrated health care services to pregnant 
        and postpartum women under section 330P of the Public Health 
        Service Act (including, if applicable, the State).
    ``(e) Monitoring.--A State shall include in the State plan 
amendment--
            ``(1) a methodology for tracking reductions in inpatient 
        days and reductions in the total cost of care resulting from 
        improved care coordination and management under this section;
            ``(2) a proposal for use of health information technology 
        in providing an eligible individual with pregnancy and 
        postpartum coordinated care services as specified under this 
        section and improving service delivery and coordination across 
        the care continuum; and
            ``(3) a methodology for tracking prompt and timely access 
        to medically necessary care for eligible individuals from out-
        of-State providers.
    ``(f) Data Collection.--
            ``(1) Provider reporting requirements.--In order to receive 
        payments from a State under subsection (c), a maternity health 
        home, or a designated provider, a team of health care 
        professionals operating with such a provider, or a health team 
        designated as a maternity health home, shall report to the 
        State, at such time and in such form and manner as may be 
        required by the State, including through a health information 
        exchange or other public health data sharing entity, the 
        following information:
                    ``(A) With respect to each such designated 
                provider, team of health care professionals operating 
                with such a provider, and health team designated as a 
                maternity health home, the name, National Provider 
                Identification number, address, and specific health 
                care services offered to be provided to any eligible 
                individual who has selected such provider, team of 
                health care professionals, or health team as the 
                eligible individual's maternity health home.
                    ``(B) Information on all other applicable measures 
                for determining the quality of services provided by 
                such provider, team of health care professionals, or 
                health team.
                    ``(C) Information concerning the factors described 
                in paragraph (2)(A)(vi) received from health risk 
                assessments of eligible individuals conducted and 
                completed by the designated provider, team of health 
                care professionals operating with such a provider, or 
                health team designated as a maternity health home.
                    ``(D) Such other information as the Secretary shall 
                specify in guidance.
            ``(2) State reporting requirements.--
                    ``(A) Comprehensive report.--A State with a State 
                plan amendment approved under this section shall report 
                to the Secretary (and, upon request, to the Medicaid 
                and CHIP Payment and Access Commission), at such time, 
                but at a minimum annually, and in such form and manner 
                determined by the Secretary to be reasonable and 
                minimally burdensome, the following information:
                            ``(i) Information described in paragraph 
                        (1).
                            ``(ii) The number and, to the extent 
                        available and while maintaining all relevant 
                        privacy and confidentially protections, 
                        disaggregated demographic information 
                        (including information on geography) of 
                        eligible individuals who have enrolled in a 
                        maternity health home pursuant to this section.
                            ``(iii) The number of maternity health 
                        homes in the State designated under this 
                        section.
                            ``(iv) The medical conditions or factors 
                        that contribute to severe maternal morbidity 
                        among eligible individuals enrolled in 
                        maternity health homes in the State.
                            ``(v) The extent to which such individuals 
                        receive health care items and services under 
                        the State plan before, during, and after an 
                        individual's enrollment in such a maternity 
                        health home.
                            ``(vi) Where applicable, mortality data and 
                        data for the associated causes of pregnancy-
                        related death for eligible individuals enrolled 
                        in a maternity health home under this section, 
                        in accordance with subsection (g). For deaths 
                        occurring postpartum, such data shall 
                        distinguish between deaths occurring up to 42 
                        days postpartum and deaths occurring between 43 
                        days to up to 1 year postpartum. Where 
                        applicable, data reported under this clause 
                        shall be reported alongside comparable data 
                        from a State's maternal mortality review 
                        committee, as established in accordance with 
                        section 317K(d) of the Public Health Service 
                        Act, for purposes of further identifying and 
                        comparing statewide trends in maternal 
                        mortality among populations participating in 
                        the maternity health home under this section.
                    ``(B) Implementation report.--Not later than 18 
                months after a State has a State plan amendment 
                approved under this section, the State shall submit to 
                the Secretary, and make publicly available on the 
                appropriate State website, a report on how the State is 
                implementing the option established under this section, 
                including through any best practices adopted by the 
                State.
    ``(g) Confidentiality.--A State with a State plan amendment under 
this section shall establish confidentiality protections for the 
purposes of subsection (f)(2)(A) to ensure, at a minimum, that there is 
no disclosure by the State of any identifying information about any 
specific eligible individual enrolled in a maternity health home or any 
maternal mortality case, and that all relevant confidentiality and 
privacy protections, including the requirements under section 
1902(a)(7)(A), are maintained.
    ``(h) Rule of Construction.--Nothing in this section shall be 
construed to require--
            ``(1) an eligible individual to enroll in a maternity 
        health home under this section; or
            ``(2) a designated provider or health team to act as a 
        maternity health home and provide services in accordance with 
        this section if the provider or health team does not 
        voluntarily agree to act as a maternity health home.
    ``(i) Planning Grants.--
            ``(1) In general.--Beginning January 1, 2027, from the 
        amount appropriated under paragraph (2), the Secretary shall 
        award planning grants to States for purposes of developing and 
        submitting a State plan amendment under this section. The 
        Secretary shall award a grant to each State that applies for a 
        grant under this subsection and meets the application criteria 
        established by the Secretary, and the Secretary may determine 
        the amount of the grant based on the merits of the application 
        and the goal of the State to prioritize health outcomes for 
        eligible individuals. A planning grant awarded to a State under 
        this subsection shall remain available until expended.
            ``(2) Appropriation.--There are authorized to be 
        appropriated to the Secretary $50,000,000 for fiscal year 2027, 
        for the purposes of making grants under this subsection, to 
        remain available until expended.
            ``(3) Limitation.--The total amount of payments made to 
        States under this subsection shall not exceed $50,000,000.
    ``(j) Additional Definitions.--In this section:
            ``(1) Designated provider.--The term `designated provider' 
        means a physician (including an obstetrician-gynecologist or, 
        if applicable, a certified nurse midwife, or certified 
        professional midwife who meets or exceeds the education and 
        training standards of the International Confederation of 
        Midwives and who is licensed to practice within the State), a 
        hospital, clinical practice or clinical group practice, rural 
        health clinic, community health center, community mental health 
        center, or any other entity or provider that is determined by 
        the State and approved by the Secretary to be qualified to be a 
        maternity health home on the basis of documentation evidencing 
        that the entity or provider has the systems, expertise, and 
        infrastructure in place to provide pregnancy and postpartum 
        coordinated care services. Such term may include providers who 
        are employed by, or affiliated with, a hospital.
            ``(2) Health team.--The term `health team' has the meaning 
        given such term for purposes of section 3502 of Public Law 111-
        148.
            ``(3) Maternity health home.--The term `maternity health 
        home' means a designated provider (including a provider that 
        operates in coordination with a team of health care 
        professionals) or a health team that is selected by an eligible 
        individual to provide pregnancy and postpartum coordinated care 
        services.
            ``(4) Pregnancy and postpartum coordinated care services.--
                    ``(A) In general.--The term `pregnancy and 
                postpartum coordinated care services' means items and 
                services related to the coordination of care for 
                comprehensive and timely high-quality, culturally and 
                linguistically appropriate, services described in 
                subparagraph (B) that are provided by a designated 
                provider, a team of health care professionals operating 
                with such a provider, or a health team designated as a 
                maternity health home.
                    ``(B) Services described.--
                            ``(i) In general.--The services described 
                        in this subparagraph shall include with respect 
                        to a State electing the State plan amendment 
                        option under this section, any medical 
                        assistance for items and services for which 
                        payment is available under the State plan or 
                        under a waiver of such plan.
                            ``(ii) Other items and services.--In 
                        addition to medical assistance described in 
                        clause (i), the services described in this 
                        subparagraph shall include the following:
                                    ``(I) Any item or service for which 
                                medical assistance is otherwise 
                                available under the State plan (or a 
                                waiver of such plan) related to the 
                                treatment of an individual during the 
                                individual's pregnancy and the 1-year 
                                period beginning on the last day of 
                                such pregnancy, including mental health 
                                and substance use disorder services.
                                    ``(II) Comprehensive care 
                                management.
                                    ``(III) Care coordination 
                                (including with pediatricians as 
                                appropriate), health promotion, and 
                                providing access to the full range of 
                                maternal, obstetric, and gynecologic 
                                services, including services from out-
                                of-State providers.
                                    ``(IV) Comprehensive transitional 
                                care, including appropriate follow-up, 
                                from inpatient to other settings.
                                    ``(V) Patient and family support 
                                (including authorized representatives).
                                    ``(VI) Referrals to community and 
                                social support services, if relevant.
                                    ``(VII) Use of health information 
                                technology to link services, as 
                                feasible and appropriate.
            ``(5) Team of health care professionals.--The term `team of 
        health care professionals' means a team of health care 
        professionals (as described in the State plan amendment under 
        this section) that may--
                    ``(A) include--
                            ``(i) physicians, including gynecologist-
                        obstetricians, certified nurse midwives, or 
                        certified professional midwives who meet or 
                        exceed the education and training standards of 
                        the International Confederation of Midwives and 
                        who are licensed to practice within the State, 
                        family physicians, primary care physicians, 
                        pediatricians, and other professionals such as 
                        physicians assistants, advance practice nurses, 
                        nurses, nurse care coordinators, dietitians, 
                        nutritionists, social workers, behavioral 
                        health professionals, physical counselors, 
                        physical therapists, occupational therapists, 
                        or any professionals that assist in prenatal 
                        care, delivery, or postpartum care for which 
                        medical assistance is available under the State 
                        plan or a waiver of such plan and determined to 
                        be appropriate by the State and approved by the 
                        Secretary;
                            ``(ii) an entity or individual who is 
                        designated to coordinate such care delivered by 
                        the team; and
                            ``(iii) when appropriate and if otherwise 
                        eligible to furnish items and services that are 
                        reimbursable as medical assistance under the 
                        State plan or under a waiver of such plan, 
                        doulas, community health workers, translators 
                        and interpreters, and other individuals with 
                        culturally appropriate and trauma-informed 
                        expertise; and
                    ``(B) provide care at a facility that is 
                freestanding, virtual, or based at a hospital, 
                community health center, community mental health 
                center, rural health clinic, clinical practice or 
                clinical group practice, academic health center, or any 
                entity determined to be appropriate by the State and 
                approved by the Secretary.''.
    (b) Applicability to CHIP.--Section 2107(e)(1) of the Social 
Security Act (42 U.S.C. 1397gg(e)(1)), as amended by section 105, is 
amended by adding at the end the following new subparagraph:
                    ``(W) Section 1945B (relating to optional health 
                homes for pregnant and postpartum individuals).''.

SEC. 203. GUIDANCE ON SUPPORTING AND IMPROVING ACCESS TO MEDICAID AND 
              CHIP COVERAGE OF SERVICES PROVIDED BY DOULAS AND CERTAIN 
              MATERNAL HEALTH PROFESSIONALS.

    Not later than 1 year after the date of the enactment of this Act, 
the Secretary of Health and Human Services shall issue and publish 
guidance for States concerning options for supporting and improving 
access to coverage and payment under a State plan under title XIX of 
the Social Security Act (42 U.S.C. 1396 et seq.) or under a waiver of 
such plan, and under a State child health plan under title XXI of such 
Act (42 U.S.C. 1397aa et seq.) or under a waiver of such plan, for 
services provided by doulas, certified nurse midwives, certified 
midwives, or certified professional midwives, who meet or exceed the 
education and training standards of the International Confederation of 
Midwives and who are licensed to practice within the State and certain 
maternal health professionals (specified by the Secretary)--
            (1) in rural areas;
            (2) across a continuum of care; and
            (3) among varied provider settings and payment and care 
        models, including managed care.

SEC. 204. MEDICAID AND CHIP INCREASED FINANCIAL SUPPORT FOR DEPRESSION 
              AND ANXIETY SCREENING DURING THE PERINATAL AND POSTPARTUM 
              PERIODS.

    (a) Medicaid.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d), as amended by section 103, is further amended--
            (1) in the first sentence of subsection (b), by striking 
        ``subsection (a)(4)(D)'' and inserting ``subsections (a)(4)(D) 
        and (ll)''; and
            (2) by adding at the end the following:
    ``(ll) Increased FMAP for Depression and Anxiety Screening During 
the Perinatal and Postpartum Periods.--
            ``(1) In general.--For purposes of clause (5) of the first 
        sentence of subsection (b), services described in this 
        subsection are screening services provided to an individual who 
        is eligible for such assistance on the basis of being pregnant 
        that include at a minimum--
                    ``(A) during the perinatal period, at least 1 
                screening for depression and anxiety symptoms using a 
                standardized, validated tool; and
                    ``(B) during the postpartum period, a full 
                assessment of mood and emotional well-being, including 
                screening for postpartum depression and anxiety, using 
                a standardized, validated tool.
            ``(2) Exclusion from territorial caps.--The additional 
        amount paid to a territory for expenditures for medical 
        assistance for services described in paragraph (1) as a result 
        of the application of clause (5) of the first sentence of 
        subsection (b) shall not be taken into account for purposes of 
        applying payment limits under subsections (f) and (g) of 
        section 1108.''.
    (b) CHIP.--Section 2105(c) of the Social Security Act (42 U.S.C. 
1397ee(c)) is amended by adding at the end the following new paragraph:
            ``(13) Enhanced payment for depression and anxiety 
        screening during the perinatal and postpartum periods.--
        Notwithstanding subsection (b), the enhanced FMAP with respect 
        to payments under subsection (a) for expenditures under the 
        State child health plan (or a waiver of such plan) shall be 
        increased by 1 percentage point with respect to expenditures 
        for services described in section 1905(ll)(1) that are provided 
        under the plan (or waiver) to an individual who is eligible for 
        such assistance on the basis of being pregnant (including 
        pregnancy-related assistance provided to a targeted low-income 
        pregnant woman (as defined in section 2112(d)), pregnancy-
        related assistance provided to an individual who is eligible 
        for such assistance through application of section 
        1903(v)(4)(A)(i) under section 2107(e)(1), or any other 
        assistance under the plan (or waiver) provided to an individual 
        who is eligible for such assistance on the basis of being 
        pregnant) and during the 12-month period that begins on the 
        last day of the individual's pregnancy and ends on the last day 
        of the month in which such 12-month period ends (including any 
        such assistance provided during the month in which such period 
        ends).''.
    (c) Effective Date.--The amendments made by this section shall take 
effect on the first day of the first fiscal quarter that begins on or 
after the date that is 1 year after the date of enactment of this 
section.

SEC. 205. PRESUMPTIVE ELIGIBILITY FOR PREGNANT INDIVIDUALS.

    (a) In General.--
            (1) Requirement.--Section 1920(a) of the Social Security 
        Act (42 U.S.C. 1396r-1(a)) is amended by striking ``may 
        provide'' and inserting ``shall provide''.
            (2) Application.--Section 1920 of the Social Security Act 
        (42 U.S.C. 1396r-1) is amended by adding at the end the 
        following new subsection:
    ``(f) Application.--A State shall provide to a pregnant woman a 
presumptive eligibility period in accordance with this section without 
regard to whether the individual would otherwise qualify for a 
presumptive eligibility period the State has elected to provide under 
section 1920A, 1920B, or 1920C.''.
    (b) Conforming Amendments.--
            (1) Section 1902(a)(47) of the Social Security Act (42 
        U.S.C. 1396a(a)(47)) is amended to read as follows:
            ``(47) provide--
                    ``(A)(i) for making ambulatory prenatal care 
                available to pregnant women during a presumptive 
                eligibility period in accordance with section 1920; and
                    ``(ii) at the option of the State--
                            ``(I) for making medical assistance for 
                        items and services described in subsection (a) 
                        of section 1920A available to children during a 
                        presumptive eligibility period in accordance 
                        with such section;
                            ``(II) for making medical assistance 
                        available to individuals described in 
                        subsection (a) of section 1920B during a 
                        presumptive eligibility period in accordance 
                        with such section; and
                            ``(III) for making medical assistance 
                        available to individuals described in 
                        subsection (a) of section 1920C during a 
                        presumptive eligibility period in accordance 
                        with such section; and
                    ``(B) that any hospital that is a participating 
                provider under the State plan may elect to be a 
                qualified entity for purposes of determining, on the 
                basis of preliminary information, whether any 
                individual is eligible for medical assistance under the 
                State plan or under a waiver of the plan for purposes 
                of providing the individual with medical assistance 
                during a presumptive eligibility period, in the same 
                manner, and subject to the same requirements, as apply 
                with respect to populations described in section 1920, 
                1920A, 1920B, or 1920C (without regard to whether the 
                State has elected to provide for a presumptive 
                eligibility period under sections 1920A, 1920B, or 
                1920C), subject to such guidance as the Secretary shall 
                establish;''.
            (2) Section 1920(e) of the Social Security Act (42 U.S.C. 
        1396r-1(e)) is amended--
                    (A) by striking ``If the State has elected the 
                option to provide a presumptive eligibility period 
                under this section or section 1920A, the'' and 
                inserting ``The''; and
                    (B) by striking ``1920A, subject to'' and inserting 
                ``1920A (if the State has elected the option), subject 
                to''.
            (3) Section 2107(e)(1)(R) of the Social Security Act (42 
        U.S.C. 1397gg(e)(1)(R)) is amended by inserting ``1920 
        (relating to presumptive eligibility for pregnant women and 
        section'' before ``1920A''.
            (4) Section 2112(c) of the Social Security Act (42 U.S.C. 
        1397ll(c)) is amended--
                    (A) in the heading, by striking ``Option To 
                Provide''; and
                    (B) by striking ``may elect'' and inserting ``shall 
                elect''.

        TITLE III--INVEST IN THE MATERNAL HEALTH CARE WORKFORCE

SEC. 301. EMERGENCY OBSTETRIC WORKFORCE SUPPORT.

    (a) In General.--Section 203A of the Public Health Service Act (42 
U.S.C. 204a) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), in the matter preceding 
                subparagraph (A), by inserting ``and urgent maternal 
                health care needs'' after ``public health care needs'';
                    (B) in paragraph (3), by inserting ``or urgent 
                maternal health care need'' after ``public health care 
                need'';
                    (C) in paragraph (5)--
                            (i) in subparagraph (C), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (D), by striking the 
                        period at the end and inserting ``; or''; and
                            (iii) by adding at the end the following:
                    ``(E) any urgent need, not rising to the level of 
                an emergency described in subparagraph (D), that, in 
                the judgment of the Secretary, if not addressed, could 
                result in an emergency that would be appropriate for 
                the deployment of the Commissioned Corps.''; and
                    (D) by adding at the end the following:
            ``(6) Urgent maternal health care need.--
                    ``(A) In general.--For purposes of this section and 
                section 214, the term `urgent maternal health care 
                need', with respect to an area, means a maternal health 
                care need, as determined by the Secretary, in 
                consultation with the Attorney General, arising as a 
                result of the closure or imminent closure of a hospital 
                or other health care facility in such area, or the loss 
                of workers employed by such hospital or health care 
                facility who are trained to provide maternal health 
                care services.
                    ``(B) Considerations.--In determining whether there 
                is an urgent maternal health care need for purposes of 
                subparagraph (A) with respect to an area, the Secretary 
                shall consider whether such closure, imminent closure, 
                or loss of workers has impacted access by individuals 
                in such area to a full range of maternal health care 
                services, including prenatal services, labor and 
                delivery services, postnatal services, maternal and 
                postpartum mental health services, behavioral health 
                services, and reproductive health services.'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by inserting ``or urgent 
                maternal health care needs'' after ``public health care 
                needs''; and
                    (B) in each of paragraphs (2) and (4)(B), by 
                inserting ``or urgent maternal health care need'' after 
                ``public health care need''; and
            (3) in subsection (c), by inserting ``or urgent maternal 
        health care need'' after ``public health care need''.
    (b) Detail of Personnel.--Section 214 of the Public Health Service 
Act (42 U.S.C. 215) is amended--
            (1) by redesignating subsection (e) as subsection (f);
            (2) by inserting after subsection (d) the following:
    ``(e)(1) Upon the request of an eligible entity with respect to a 
hospital or other health care facility the closure, imminent closure, 
or loss of workers of which led to an urgent maternal health care need 
in an area, personnel may be detailed by the Secretary for the purpose 
of assisting such eligible entity in work related to such urgent 
maternal health care need.
    ``(2)(A) Personnel detailed under paragraph (1) shall be paid from 
applicable appropriations of the Service.
    ``(B) In the case of detail of personnel under paragraph (1) to be 
paid from applicable Service appropriations, the Secretary may 
condition such detail on an agreement by the eligible entity concerned 
that such eligible entity concerned shall reimburse the United States 
for a portion of the amount of such payments made by the Service.
    ``(C) The services of personnel while detailed pursuant to this 
subsection shall be considered as having been performed in the Service 
for purposes of the computation of basic pay, promotion, retirement, 
compensation for injury or death, and the benefits provided by section 
212.
    ``(3) The Secretary may condition a detail of personnel under 
paragraph (1) on an agreement by the eligible entity concerned that 
such eligible entity concerned shall--
            ``(A) in the case of an imminent closure or a loss of 
        workers, as determined by the Secretary--
                    ``(i) maintain the maternal health care services in 
                the applicable area to the maximum extent practicable, 
                including by hiring temporary workers, until the date 
                on which the personnel are detailed to such area; and
                    ``(ii) submit to the Secretary a plan for hiring 
                and retaining health practitioners in the short- and 
                long-term, both during periods in which personnel are 
                detailed to such applicable area and periods in which 
                personnel are not detailed to such applicable area;
            ``(B) in the case of a closure, submit to the Secretary a 
        plan for working with, as applicable, State and local agencies 
        and local stakeholders to transition patients to alternate 
        sources of safe maternal health care services; and
            ``(C) commit to an assessment by the Secretary of the 
        workplace practices of such eligible entity concerned, if 
        applicable.
    ``(4) In this subsection--
            ``(A) the term `eligible entity' means--
                    ``(i) a State;
                    ``(ii) a political subdivision of a State; or
                    ``(iii) a Tribal, nonprofit, or other health care 
                entity; and
            ``(B) the term `personnel' means an employee or officer of 
        the Commissioned Corps.''; and
            (3) in subsection (f) (as so redesignated), by inserting 
        ``or an urgent maternal health care need'' before the period at 
        the end.
    (c) Funding for Commissioned Corps of the Public Health Service.--
Section 203 of the Public Health Service Act (42 U.S.C. 204) is amended 
by adding at the end the following:
    ``(e) Operations of the Commissioned Corps of the Public Health 
Service.--
            ``(1) In general.--The Secretary shall carry out duties and 
        responsibilities relating to the operations of the Commissioned 
        Corps of the Service, including the following:
                    ``(A) Enhance the processes and systems of the 
                Service's Headquarters operations.
                    ``(B) Maximize the force management, required 
                training opportunities (as determined by the Secretary 
                under section 203A(a)(1)), operational capacity, and 
                mission readiness of the Regular Corps, the Ready 
                Reserve Corps, and the Public Health Emergency Response 
                Strike Teams, a subcomponent of the Regular Corps.
                    ``(C) Recruit and retain qualified professionals 
                suited to serving underserved and vulnerable 
                communities by--
                            ``(i) improving onboarding timelines, 
                        providing officer placements to align with 
                        mission needs, ensuring adequate officer morale 
                        and wellness resources, and incentivizing 
                        recruiters and recruits; and
                            ``(ii) expanding training opportunities, 
                        including training of personnel to deliver 
                        maternal health care services, providing 
                        credentialing support for high demand skill 
                        sets, and enriching leadership and research 
                        potential.
                    ``(D) Improve deployment processes and prepare 
                mission teams to execute routine and emergent public 
                health events.
                    ``(E) Establish a legislative liaison office to 
                carry out legislative affairs functions under the 
                direction of the Secretary.
            ``(2) Authorization of appropriations.--In addition to 
        amounts otherwise authorized to be appropriated for the 
        Commissioned Corps of the Service, there is authorized to be 
        appropriated to the Secretary to carry out paragraph (1) 
        $150,000,000 for fiscal year 2026 and each fiscal year 
        thereafter.''.

SEC. 302. STREAMLINED SCREENING AND ENROLLMENT OF PROVIDERS OF 
              MATERNITY, LABOR, AND DELIVERY SERVICES IN NEIGHBORING 
              STATES.

    (a) Application to Medicaid.--Section 1902(kk) of the Social 
Security Act (42 U.S.C. 1396a(kk)) is amended by adding at the end the 
following new paragraph:
            ``(10) Streamlined enrollment process for eligible out-of-
        state providers of maternity, labor, and delivery services.--
                    ``(A) In general.--The State adopts and implements 
                a process that enables an eligible out-of-State 
                provider to enroll as a provider in the State plan 
                without imposing any screening requirements that are in 
                addition to the requirements imposed on in-State 
                providers. An eligible out-of-State provider that 
                enrolls in the State plan through such process shall be 
                so enrolled for a 5-year period (unless the provider is 
                terminated or excluded from participation during such 
                period) and may revalidate such enrollment through such 
                process for subsequent 5-year periods.
                    ``(B) Eligible out-of-state provider.--In this 
                paragraph, the term `eligible out-of-State provider' 
                means, with respect to a State, a provider--
                            ``(i) that furnishes maternity, labor, and 
                        delivery services (as defined in subsection 
                        (uu)(1)), or provides orders or referrals for 
                        such services, for which payment is available 
                        under the State plan of the State;
                            ``(ii) that is located in a neighboring 
                        State (as defined by the Secretary);
                            ``(iii) with respect to which the Secretary 
                        has determined there is a limited risk of 
                        fraud, waste, or abuse for purposes of 
                        determining the level of screening to be 
                        conducted under section 1866(j)(2)(B);
                            ``(iv) that has been screened under such 
                        section 1866(j)(2)(B) for purposes of enrolling 
                        in the Medicare program under title XVIII or 
                        the State plan of the State in which such 
                        provider is located; and
                            ``(v) that has not been excluded from 
                        participation in the Medicare program under 
                        such title or the Medicaid program under this 
                        title.''.
    (b) Conforming Amendments.--
            (1) Section 1902(a)(77) of the Social Security Act (42 
        U.S.C. 1396a(a)(77)) is amended by inserting ``enrollment,'' 
        after ``screening,''.
            (2) Section 1902(kk) of such Act (42 U.S.C. 1396a(kk)), as 
        amended by subsection (a), is further amended--
                    (A) in the subsection heading, by inserting 
                ``Enrollment,'' after ``Screening,''; and
                    (B) in paragraph (9), by striking ``Nothing'' and 
                inserting ``Except as provided in paragraph (10), 
                nothing''.
    (c) Application to CHIP.--Section 2107(e)(1)(G) of such Act (42 
U.S.C. 1397gg(e)(1)(G)) is amended by inserting ``enrollment,'' after 
``screening,''.
    (d) Guidance on Screening and Enrolling Out-of-State Providers of 
Maternity, Labor, and Delivery Services.--Not later than January 1, 
2027, the Secretary of Health and Human Services shall issue (and 
update as the Secretary determines necessary) guidance to State 
Medicaid and CHIP directors on best practices for screening and 
enrolling out-of-State providers of maternity, labor, and delivery 
services in accordance with paragraph (10) of section 1902(kk) of the 
Social Security Act (42 U.S.C. 1396a(kk)) and section 2107(e)(1)(G) of 
such Act (42 U.S.C. 1397gg(e)(1)(G)) (as added and amended by this 
section) and including best practices for screening and enrolling out-
of-State providers in managed care plans.
    (e) Effective Date.--The amendments made by this section take 
effect on January 1, 2027.

 TITLE IV--REQUIRING PUBLIC COMMUNICATION OF OBSTETRICS DATA AND UNIT 
                                CLOSURES

SEC. 401. TIMELY NOTIFICATIONS OF IMPENDING HOSPITAL OBSTETRIC UNIT 
              CLOSURES.

    (a) In General.--Section 1866(a)(1) of the Social Security Act (42 
U.S.C. 1395cc(a)(1)) is amended--
            (1) in subparagraph (X), by striking ``and'' at the end;
            (2) in subparagraph (Y)(ii)(V), by striking the period and 
        inserting ``, and''; and
            (3) by inserting after subparagraph (Y) the following new 
        subparagraph:
                    ``(Z) beginning 180 days after the date of the 
                enactment of this subparagraph, in the case of a 
                hospital, not less than 180 days prior to the closure 
                of any obstetric unit of the hospital, to submit to the 
                Secretary, any relevant local and State agencies, and 
                the community a notification, which shall include--
                            ``(i) a report analyzing the impact the 
                        closure will have on the community, including 
                        data on any adverse outcomes and increase in 
                        costs relating to obstetric services for such 
                        community;
                            ``(ii) steps the hospital will take to 
                        identify other health care providers that can 
                        alleviate any service gaps as a result of the 
                        closure;
                            ``(iii) the cause of the closure of such 
                        obstetric unit;
                            ``(iv) data regarding historic 
                        transportation costs related to obstetric 
                        services in such community; and
                            ``(v) any additional information as may be 
                        required by the Secretary.''.
    (b) State Requirement To Post Reports.--Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)), as amended by section 
201(a)(1), is further amended--
            (1) in paragraph (87), by striking ``and'' at the end;
            (2) in paragraph (88), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (88) the following new 
        paragraph:
            ``(89) provide that the State will make publicly available, 
        on the website of any relevant State agency, any report 
        received by the State from a hospital pursuant to section 
        1866(a)(1)(Z)(i).''; and

SEC. 402. COLLECTION OF DATA RELATING TO HOSPITAL LABOR AND DELIVERY 
              SERVICES.

    Section 1866(a)(1) of the Social Security Act (42 U.S.C. 
1395cc(a)(1)), as amended by section 401, is amended--
            (1) in subparagraph (Y)(ii)(V), by striking ``and'' at the 
        end;
            (2) in subparagraph (Z), by striking the period and 
        inserting ``, and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(AA) in the case of a hospital, to include in 
                cost reports submitted under this title for cost 
                reporting periods beginning on or after July 1, 2025--
                            ``(i) the number of births that occurred at 
                        such hospital during the cost reporting period, 
                        delineated by the number of cesarean births and 
                        vaginal births;
                            ``(ii) the number of antenatal and 
                        postpartum transfers from the hospital to other 
                        hospitals;
                            ``(iii) data on the number and 
                        characteristics of the staff providing labor 
                        and delivery services at such hospital;
                            ``(iv) the expenses the hospital incurred 
                        for providing labor and delivery services at 
                        such hospital, including nursing care, 
                        anesthesia, and operating room services;
                            ``(v) the amount the hospital spent for on-
                        call coverage for labor and delivery services 
                        by physicians and midwives; and
                            ``(vi) the amount and sources of revenue 
                        received by such hospital for labor and 
                        delivery services, including payments received 
                        for--
                                    ``(I) items and services furnished 
                                to individuals eligible for coverage 
                                under a State plan under title XIX (or 
                                a waiver of such a plan);
                                    ``(II) items and services furnished 
                                to individuals with other forms of 
                                health insurance or third-party 
                                coverage; and
                                    ``(III) items and services 
                                furnished to individuals without health 
                                insurance or other source of third-
                                party coverage.''.
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