I 

115TH CONGRESS 

1ST SESSION H. R. 1318 

To support States in their work to save and sustain the health of mothers 

during pregnancy, childbirth, and in the postpartum period, to eliminate 

disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve health care 

quality and health outcomes for mothers, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 2, 2017 

Ms. HERRERA BEUTLER (for herself, Mr. CONYERS, Mr. COSTELLO of Pennsylvania, and Ms. DEGETTE) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To support States in their work to save and sustain the 

health of mothers during pregnancy, childbirth, and in 

the postpartum period, to eliminate disparities in maternal health outcomes for pregnancy-related and pregnancy-associated deaths, to identify solutions to improve 

health care quality and health outcomes for mothers, 

and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Preventing Maternal 

3 Deaths Act of 2017’’. 

4 SEC. 2. FINDINGS; PURPOSES. 

5 (a) FINDINGS.—Congress finds the following: 

6 (1) The United States is ranked 50th globally 

7 for its maternal mortality rate, and it is one of eight 

8 countries in which the maternal mortality rate has 

9 been on the rise. 

10 (2) In recent studies, the estimated maternal 

11 mortality rate in the United States increased by ap12 proximately 26.6 percent from 2000 to 2014, with 

13 the rate increasing in nearly all States. This re14 ported increase, along with no improvement in pre15 vious years, remains a source of great concern for 

16 the Centers for Disease Control and Prevention 

17 (CDC), health care providers, and patient advocates 

18 such as the American Congress of Obstetricians and 

19 Gynecologists, the Association of Women’s Health, 

20 Obstetric, and Neonatal Nurses, and the 

21 Preeclampsia Foundation. 

22 (3) Maternal deaths in the United States result 

23 from pregnancy-related causes such as hemorrhage, 

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1 dose, and violent causes such as motor vehicle acci2 dents, homicide, and suicide. 

3 (4) Review of pregnancy-related and pregnancy4 associated deaths is essential to determining strate5 gies for developing prevention efforts and quality im6 provement and quality control programs. The United 

7 States must identify at-risk populations and under8 stand how to support them to make pregnancy and 

9 the postpartum period safer. 

10 (5) The most severe complications of preg11 nancy, generally referred to as severe maternal mor12 bidity (SMM), affect more than 65,000 women in 

13 the United States every year. The CDC uses ICD– 

14 9–CM codes, which indicate a potentially life-threat15 ening maternal condition or complication, to define 

16 SMM. 

17 (6) Data from the CDC shows Black women 

18 are three times more likely to die from complications 

19 of pregnancy or childbirth than White women: 42.8 

20 Black women per 100,000 live births, as opposed to 

21 12.5 White women and 17.3 women of other races. 

22 (7) The CDC recommends that maternal deaths 

23 be investigated through State collaboratives. These 

24 State collaboratives would bring together leaders in 

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1 demic, and public health care settings to make rec2 ommendations for preventing pregnancy-related and 

3 pregnancy-associated deaths and health complica4 tions and identify ways to improve quality of care 

5 for women and infants. 

6 (8) A few States, including California, have 

7 worked to develop and strengthen maternal mor8 bidity and mortality review systems and utilize data 

9 to reduce maternal deaths and injuries to address 

10 leading issues such as maternal hemorrhage, hyper11 tension and preeclampsia, and health and racial dis12 parities. 

13 (b) PURPOSES.—The purposes of this Act are the fol14 lowing: 

15 (1) To establish a shared responsibility between 

16 States and the Federal Government to identify op17 portunities for improvement in quality of care and 

18 system changes, and to educate and inform health 

19 institutions and professionals, women, and families 

20 about preventing pregnancy-related and pregnancy21 associated deaths and complications and reducing 

22 disparities. 

23 (2) To develop a model for States to operate 

24 maternal mortality reviews and assess the various 

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1 tality, including quality of care, racial disparities, 

2 and systemic problems in the delivery of health care, 

3 and to develop appropriate interventions to reduce 

4 and prevent such deaths. 

5 SEC. 3. STATE MATERNAL MORTALITY REVIEW COMMIT6 TEES ON PREGNANCY-RELATED AND PREG7 NANCY-ASSOCIATED DEATHS. 

8 (a) PROGRAM AUTHORIZED.— 

9 (1) IN GENERAL.—The Secretary of Health and 

10 Human Services, through the Director of the Cen11 ters for Disease Control and Prevention, shall estab12 lish a grant program under which the Secretary may 

13 make grants to States for the purpose of— 

14 (A) carrying out the activities described in 

15 subsection (b)(1); 

16 (B) establishing and sustaining a State 

17 maternal mortality review committee, in accord18 ance with subsection (b)(2); 

19 (C) ensuring that the State department of 

20 health carries out the activities described in 

21 subsection (b)(3); 

22 (D) disseminating the case abstraction 

23 form developed under subsection (c); and 

24 (E) providing for the public disclosure of 

25 information, in accordance with subsection (d). 


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1 (2) CRITERIA.—The Secretary shall establish 

2 criteria for determining eligibility for, and the 

3 amount of a grant awarded to, a State under para4 graph (1). Such criteria shall provide that in the 

5 case of a State that receives a grant under para6 graph (1) for a fiscal year and is determined by the 

7 Secretary to have not used such grant in accordance 

8 with this section, such State may not be eligible for 

9 such a grant for any subsequent fiscal year. 

10 (b) USE OF FUNDS.— 

11 (1) REVIEW OF PREGNANCY-RELATED AND

12 PREGNANCY-ASSOCIATED DEATHS.—With respect to 

13 a State that receives a grant under subsection 

14 (a)(1), the following shall apply: 

15 (A) PROCESS FOR MANDATORY REPORTING

16 OF PREGNANCY-RELATED AND PREGNANCY-AS17 SOCIATED DEATHS.— 

18 (i) IN GENERAL.—The State, through 

19 the State maternal mortality review com20 mittee established under subsection (a)(1), 

21 shall develop a process that provides for 

22 mandatory and confidential case reporting 

23 to the State department of health by indi24 viduals and entities described in clause (ii) 


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1 with respect to pregnancy-related and 

2 pregnancy-associated deaths. 

3 (ii) INDIVIDUALS AND ENTITIES DE4 SCRIBED.—Individuals and entities de5 scribed in this clause include each of the 

6 following: 

7 (I) Health care professionals. 

8 (II) Medical examiners. 

9 (III) Medical coroners. 

10 (IV) Hospitals. 

11 (V) Birth centers. 

12 (VI) Other health care facilities. 

13 (VII) Other individuals respon14 sible for completing death records. 

15 (VIII) Other appropriate individ16 uals or entities specified by the Sec17 retary. 

18 (B) PROCESS FOR VOLUNTARY REPORTING

19 OF PREGNANCY-RELATED AND PREGNANCY-AS20 SOCIATED DEATHS.—The State, through the 

21 State maternal mortality review committee es22 tablished under subsection (a)(1), shall develop 

23 a process that provides for voluntary and con24 fidential case reporting to the State department 

25 of health by family members of the deceased 


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1 and other individuals on possible pregnancy-re2 lated and pregnancy-associated deaths. Such 

3 process shall include— 

4 (i) making publicly available on the 

5 website of the State department of health 

6 a telephone number, Internet web link, and 

7 email address for such reporting; and 

8 (ii) publicizing to local professional or9 ganizations, community organizations, and 

10 social services agencies the availability of 

11 the telephone number, Internet web link, 

12 and email address made available under 

13 clause (i). 

14 (C) IDENTIFICATION OF PREGNANCY-RE15 LATED AND PREGNANCY-ASSOCIATED DEATHS

16 BY STATE VITAL STATISTICS UNIT.—The State, 

17 through the vital statistics unit of the State, 

18 shall annually identify pregnancy-related and 

19 pregnancy-associated deaths occurring in such 

20 State in the year involved by— 

21 (i) matching each death record of a 

22 woman in such year to a live birth certifi23 cate or an infant death record for the pur24 pose of identifying deaths of women that 


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1 occurred during pregnancy and within one 

2 year after the end of a pregnancy; 

3 (ii) identifying each death of a woman 

4 reported during such year as having an un5 derlying or contributing cause of death re6 lated to pregnancy, regardless of the time 

7 that has passed between the end of the 

8 pregnancy and the death; 

9 (iii) collecting data from medical ex10 aminer and coroner reports; and 

11 (iv) using any other method the State 

12 may devise to identify maternal deaths 

13 such as reviewing a random sample of re14 ported deaths of women to ascertain cases 

15 of pregnancy-related and pregnancy-associ16 ated deaths that are not discernable from 

17 a review of death records alone. 

18 For purposes of effectively collecting and ob19 taining data on pregnancy-related and preg20 nancy-associated deaths, the State shall adopt 

21 the most recent standardized birth and death 

22 records, as issued by the National Center for 

23 Vital Health Statistics, including the rec24 ommended checkbox section for pregnancy on 

25 each death record. 


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1 (D) CASE INVESTIGATION AND DEVELOP2 MENT OF CASE SUMMARIES.— 

3 (i) IN GENERAL.—Following the re4 ceipt of reports by the State department of 

5 health pursuant to subparagraph (A) or 

6 (B) and the collection of cases of preg7 nancy-related and pregnancy-associated 

8 deaths by the vital statistics unit of the 

9 State under subparagraph (C), the State, 

10 through the State maternal mortality re11 view committee established under sub12 section (a)(1), shall investigate each case, 

13 using the case abstraction form described 

14 in subsection (c), and prepare a de-identi15 fied case summary for each case, which 

16 shall be reviewed by the committee and in17 cluded in applicable reports. The State de18 partment of health or vital statistics unit 

19 of the State, as the case may be, shall pro20 vide the State maternal mortality review 

21 committee with access to the information 

22 collected pursuant to subparagraph (A) or 

23 (B), or under subparagraph (C), as nec24 essary to carry out this subparagraph. 


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1 (ii) MANDATORY DATA AND INFORMA2 TION.—Each case investigation under this 

3 subparagraph shall, subject to availability, 

4 include data and information obtained 

5 through— 

6 (I) medical examiner and autopsy 

7 reports of the woman involved; 

8 (II) medical records of the 

9 woman, including such records related 

10 to health care prior to pregnancy, pre11 natal and postnatal care, labor and 

12 delivery care, emergency room care, 

13 hospital discharge records, and any 

14 care delivered up until the time of 

15 death of the woman; 

16 (III) oral and written interviews 

17 of individuals directly involved in the 

18 maternal care of the woman during 

19 and immediately following the preg20 nancy of the woman, including health 

21 care, mental health, and social service 

22 providers, as applicable; 

23 (IV) socioeconomic and other rel24 evant background information about 

25 the woman; 


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1 (V) any information collected 

2 under subparagraph (C)(i); and 

3 (VI) any other information on 

4 the cause of death of the woman, such 

5 as social services and child welfare re6 ports. 

7 (iii) DISCRETIONARY DATA AND IN8 FORMATION.—Each case investigation 

9 under this subparagraph may include data 

10 and information obtained through oral or 

11 written interviews of the family of the 

12 woman. 

13 (2) STATE MATERNAL MORTALITY REVIEW

14 COMMITTEES.— 

15 (A) MANDATORY ACTIVITIES.—A State 

16 maternal mortality review committee established 

17 under subsection (a)(1) shall carry out the fol18 lowing activities: 

19 (i) Develop the processes described in 

20 subparagraphs (A) and (B) of paragraph 

21 (1). 

22 (ii) Review the data and information 

23 collected by the vital statistics unit of the 

24 State under paragraph (1)(C) regarding 

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1 ated deaths to identify trends, patterns, 

2 and disparities in adverse outcomes and 

3 address medical, non-medical, and system4 related factors that may have contributed 

5 to such pregnancy-related and pregnancy6 associated deaths and disparities. 

7 (iii) Carry out the activities described 

8 in paragraph (1)(D). 

9 (iv) Develop recommendations, based 

10 on the case summaries prepared under 

11 paragraph (1)(D) and the data and infor12 mation collected under paragraph (1)(C), 

13 to improve maternal care, social and health 

14 services, and public health policy and insti15 tutions, including improving access to ma16 ternal care and social and health services 

17 and identifying disparities in maternal care 

18 and outcomes. 

19 (B) DISCRETIONARY ACTIVITIES.— 

20 (i) IN GENERAL.—A State maternal 

21 mortality review committee established 

22 under subsection (a)(1) may, while subject 

23 to confidentiality requirements, present 

24 findings and recommendations based on 

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1 graph (1)(D) directly to a health care facil2 ity or its local or State professional organi3 zation for the purpose of— 

4 (I) instituting policy changes, 

5 educational activities, and improve6 ments in the quality of care provided 

7 by the facility; and 

8 (II) exploring and forming re9 gional collaborations. 

10 (ii) INVESTIGATION OF CASES OF SE11 VERE MATERNAL MORBIDITY.—A State 

12 maternal mortality review committee may 

13 investigate cases of severe maternal mor14 bidity and any such investigation may in15 clude data and information obtained 

16 through— 

17 (I) identified patient registries; 

18 or 

19 (II) oral or written interviews of 

20 the woman concerned and the family 

21 of such woman. 

22 (C) COMPOSITION OF STATE MATERNAL

23 MORTALITY REVIEW COMMITTEES.— 

24 (i) IN GENERAL.—A State maternal 

25 mortality review committee established 


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1 under subsection (a)(1) shall be multidisci2 plinary and diverse. Membership on the 

3 State maternal mortality review committee 

4 shall be reviewed annually by the State de5 partment of health to ensure that member6 ship representation requirements are being 

7 fulfilled in accordance with this subpara8 graph. 

9 (ii) REQUIRED MEMBERSHIP.—Each 

10 State maternal mortality review committee 

11 shall include— 

12 (I) representatives from medical 

13 specialties providing care to pregnant 

14 and postpartum patients, including 

15 obstetricians (including generalists 

16 and maternal fetal medicine special17 ists) and family practice physicians; 

18 (II) certified nurse midwives, cer19 tified midwives, and advanced practice 

20 nurses; 

21 (III) hospital-based registered 

22 nurses; 

23 (IV) representatives of the ma24 ternal and child health department of 

25 the State department of health; 


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1 (V) social service providers or so2 cial workers, including those with ex3 perience working with communities di4 verse with respect to race, ethnicity, 

5 and limited English proficiency; 

6 (VI) chief medical examiners or 

7 designees; 

8 (VII) facility representatives, 

9 such as from hospitals or birth cen10 ters; 

11 (VIII) patient advocates, commu12 nity maternal health organizations, 

13 and minority advocacy groups that 

14 represent those diverse racial and eth15 nic communities within the State that 

16 are the most affected by pregnancy17 related or pregnancy-associated deaths 

18 and by a lack of access to maternal 

19 health care services; and 

20 (IX) representatives of the de21 partments of health or public health 

22 of major cities in the State. 

23 (iii) DISCRETIONARY MEMBERSHIP.— 

24 Each State maternal mortality review com25 mittee may also include representatives 


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1 from other relevant academic, health, so2 cial service, or policy professions or com3 munity organizations on an ongoing basis, 

4 or as needed, as determined beneficial by 

5 the committee, including— 

6 (I) anesthesiologists; 

7 (II) emergency physicians; 

8 (III) pathologists; 

9 (IV) epidemiologists; 

10 (V) intensivists; 

11 (VI) nutritionists; 

12 (VII) mental health professionals; 

13 (VIII) substance use disorder 

14 treatment specialists; 

15 (IX) representatives of relevant 

16 patient and provider advocacy groups; 

17 (X) academics; 

18 (XI) paramedics; and 

19 (XII) risk management special20 ists. 

21 (iv) STAFF.—Staff of each State ma22 ternal mortality review committee shall in23 clude— 


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1 (I) vital health statisticians, ma2 ternal child health statisticians, or 

3 epidemiologists; 

4 (II) a coordinator of the State 

5 maternal mortality review committee, 

6 to be designated by the State; and 

7 (III) administrative staff. 

8 (D) OPTION FOR STATES TO ESTABLISH

9 REGIONAL MATERNAL MORTALITY REVIEW COM10 MITTEES.—States may choose to partner with 

11 one or more neighboring States to carry out the 

12 activities required of a State maternal mortality 

13 review committee under this section. In such a 

14 case, with respect to the States in such a part15 nership, any requirement under this section re16 lating to the reporting of information related to 

17 such activities shall be deemed to be fulfilled by 

18 each such State if a single such report is sub19 mitted for the partnership. 

20 (E) TREATMENT AS PUBLIC HEALTH AU21 THORITY FOR PURPOSES OF HIPAA.—For pur22 poses of applying HIPAA privacy and security 

23 law (as defined in section 3009(a)(2) of the 

24 Public Health Service Act (42 U.S.C. 300jj– 

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1 mittee and regional maternal mortality review 

2 committee established under subsection (a)(1) 

3 or subsection (b)(2)(D), as the case may be, 

4 shall be deemed to be a public health authority 

5 described in section 164.501 (and referenced in 

6 section 164.512(b)(1)(i)) of title 45, Code of 

7 Federal Regulations (or any successor regula8 tion), carrying out public health activities and 

9 purposes described in such section 

10 164.512(b)(1)(i) (or any such successor regula11 tion). 

12 (3) STATE DEPARTMENT OF HEALTH ACTIVI13 TIES.—With respect to a State that receives a grant 

14 under subsection (a)(1), the State department of 

15 health shall— 

16 (A) in consultation with the State maternal 

17 mortality review committee and in conjunction 

18 with relevant professional organizations and pa19 tient advocacy organizations, develop a plan for 

20 ongoing health care provider education, based 

21 on the findings and recommendations of the 

22 committee, in order to improve the quality of 

23 maternal care; and 

24 (B) take steps to widely disseminate the 

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1 ternal mortality review committee and imple2 ment the recommendations of the committee. 

3 (c) CASE ABSTRACTION FORM.— 

4 (1) DISSEMINATION.—The Director of the Cen5 ters for Disease Control and Prevention shall dis6 seminate a uniform case abstraction form to States 

7 and State maternal mortality review committees for 

8 the purpose of— 

9 (A) ensuring that the data and information 

10 collected and reviewed by such committees can 

11 be pooled for review by the Department of 

12 Health and Human Services and its agencies; 

13 and 

14 (B) preserving the uniformity of the infor15 mation collected for Federal public health pur16 poses. 

17 (2) PERMISSIBLE STATE MODIFICATION.—Each 

18 State may modify the form developed under para19 graph (1) for implementation and use by such State 

20 or by the State maternal mortality review committee 

21 of such State by including on such form additional 

22 information to be collected, but may not alter the 

23 standard questions on such form, in order to ensure 

24 that the information can be collected and reviewed 

25 centrally at the Federal level. 


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1 (d) PUBLIC DISCLOSURE OF INFORMATION.— 

2 (1) IN GENERAL.—For fiscal year 2018, or a 

3 subsequent fiscal year, each State receiving a grant 

4 under this section for such year shall, subject to 

5 paragraph (3), provide for the public disclosure, and 

6 submission to the information clearinghouse estab7 lished under paragraph (2), of the information in8 cluded in the report of the State under subsection 

9 (f)(1) for such year. 

10 (2) INFORMATION CLEARINGHOUSE.—The Sec11 retary shall establish an information clearinghouse, 

12 to be administered by the Director of the Centers for 

13 Disease Control and Prevention, that will maintain 

14 findings and recommendations submitted pursuant 

15 to paragraph (1) and provide such findings and rec16 ommendations for public review and research pur17 poses by State departments of health, State mater18 nal mortality review committees, health providers 

19 and institutions, and national patient and provider 

20 advocacy groups. 

21 (3) CONFIDENTIALITY OF INFORMATION.—In 

22 no case may any individually identifiable health in23 formation be provided to the public, or submitted to 

24 the information clearinghouse, under this subsection. 


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1 (e) CONFIDENTIALITY OF PROCEEDINGS OF STATE

2 MATERNAL MORTALITY REVIEW COMMITTEES.— 

3 (1) IN GENERAL.—All proceedings and activi4 ties of a State maternal mortality review committee 

5 established under subsection (a)(1), opinions of 

6 members of such a committee formed as a result of 

7 such proceedings and activities, and records ob8 tained, created, or maintained pursuant to this sec9 tion, including records of interviews, written reports, 

10 and statements procured by the Department of 

11 Health and Human Services or by any other person, 

12 agency, or organization acting jointly with the De13 partment, in connection with morbidity and mor14 tality reviews under this section, shall be confidential 

15 and may not be subject to discovery, subpoena, or 

16 introduction into evidence in any civil, criminal, leg17 islative, or other proceeding. Such records shall not 

18 be open to public inspection. 

19 (2) TESTIMONY OF MEMBERS OF COM20 MITTEE.— 

21 (A) IN GENERAL.—Members of a State 

22 maternal mortality review committee established 

23 under subsection (a)(1) may not be questioned 

24 in any civil, criminal, legislative, or other pro25 ceeding regarding information presented in, or 


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1 opinions formed as a result of, a meeting or 

2 communication of the committee. 

3 (B) CLARIFICATION.—Nothing in this sub4 section may be construed to prevent a member 

5 of a State maternal mortality review committee 

6 established under subsection (a)(1) from testi7 fying regarding information that was obtained 

8 independent of such member’s participation on 

9 the committee, or public information. 

10 (3) AVAILABILITY OF INFORMATION FOR RE11 SEARCH PURPOSES.—Nothing in this subsection may 

12 prohibit a State maternal mortality review com13 mittee established under subsection (a)(1) or the De14 partment of Health and Human Services from pub15 lishing statistical compilations and research reports 

16 that— 

17 (A) are based on confidential information, 

18 relating to morbidity and mortality reviews 

19 under this section; and 

20 (B) do not contain identifying information 

21 or any other information that could be used to 

22 ultimately identify the individuals concerned. 

23 (f) REPORTS.— 

24 (1) STATE REPORTS.—Not later than one year 

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1 quent fiscal year, each State maternal mortality re2 view committee established under subsection (a)(1) 

3 and receiving a grant under this section for such 

4 year, shall submit to the Director of the Centers for 

5 Disease Control and Prevention a report on the find6 ings and recommendations of such committee and 

7 information on the implementation of such rec8 ommendations during such year. 

9 (2) ANNUAL REPORTS TO CONGRESS.—Not 

10 later than 60 days after the deadline for State re11 ports under paragraph (1) for fiscal year 2018, and 

12 each subsequent fiscal year, the Secretary of Health 

13 and Human Services shall submit to Congress a re14 port on— 

15 (A) the findings, recommendations, and 

16 implementation information submitted by any 

17 State pursuant to paragraph (1); and 

18 (B) the status of pregnancy-related and 

19 pregnancy-associated deaths in the United 

20 States, including recommendations on methods 

21 to prevent such deaths in the United States. 

22 (g) DEFINITIONS.—In this section: 

23 (1) The term ‘‘pregnancy-associated death’’ 

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1 ing the one-year period following the date of the end 

2 of pregnancy, irrespective of the cause of such death. 

3 (2) The term ‘‘pregnancy-related death’’ means 

4 the death of a woman while pregnant or during the 

5 one-year period following the date of the end of 

6 pregnancy, irrespective of the duration of the preg7 nancy, from any cause related to, or aggravated by, 

8 the pregnancy or its management, excluding any ac9 cidental or incidental cause. 

10 (3) The term ‘‘severe maternal morbidity’’ 

11 means the physical and psychological conditions that 

12 result from, or are aggravated by, pregnancy and 

13 have an adverse effect on the health of a woman. 

14 (4) The term ‘‘State’’ means each of the 50 

15 States, the District of Columbia, and each of the 

16 territories. 

17 (5) The term ‘‘vital statistics unit’’ means the 

18 entity that is responsible for maintaining vital 

19 records for a State, including official records of live 

20 births, deaths, fetal deaths, marriages, divorces, and 

21 annulments. 

22 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

23 authorized to be appropriated to carry out this section 

24 $7,000,000 for each of fiscal years 2018 through 2022. 


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1 SEC. 4. ELIMINATING DISPARITIES IN MATERNITY HEALTH 

2 OUTCOMES. 

3 Part B of title III of the Public Health Service Act 

4 is amended by inserting after section 317T of such Act 

5 (42 U.S.C. 247b–22) the following new section: 

6 ‘‘SEC. 317U. ELIMINATING DISPARITIES IN MATERNAL 

7 HEALTH OUTCOMES. 

8 ‘‘(a) IN GENERAL.—The Secretary shall, in consulta9 tion with relevant national stakeholder organizations, such 

10 as national medical specialty organizations, national ma11 ternal child health organizations, national patient advo12 cacy organizations, and national health disparity organiza13 tions, carry out the following activities to eliminate dis14 parities in maternal health outcomes: 

15 ‘‘(1) Conduct research into the determinants 

16 and the distribution of disparities in maternal care, 

17 health risks, and health outcomes, and improve the 

18 capacity of the performance measurement infrastruc19 ture to measure such disparities. 

20 ‘‘(2) Expand access to health care services, re21 sources, and information that have been dem22 onstrated to improve the quality and outcomes of 

23 maternity care for vulnerable populations. 

24 ‘‘(3) Establish a demonstration project to com25 pare the effectiveness of interventions to reduce disVerDate Sep 11 2014 03:23 Mar 08, 2017 Jkt 069200 PO 00000 Frm 00026 Fmt 6652 Sfmt 6201 E:\BILLS\H1318.IH H1318

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1 parities in maternity services and outcomes and to 

2 implement and assess effective interventions. 

3 ‘‘(b) SCOPE AND SELECTION OF STATES FOR DEM4 ONSTRATION PROJECT.—The demonstration project 

5 under subsection (a)(3) shall be conducted in no more 

6 than 8 States, which shall be selected by the Secretary 

7 based on— 

8 ‘‘(1) applications submitted by States, which 

9 specify which regions and populations the State in10 volved will serve under the demonstration project; 

11 ‘‘(2) criteria designed by the Secretary to en12 sure that, as a whole, the demonstration project is, 

13 to the greatest extent possible, representative of the 

14 demographic and geographic composition of commu15 nities most affected by disparities; 

16 ‘‘(3) criteria designed by the Secretary to en17 sure that a variety of models are tested through the 

18 demonstration project and that such models include 

19 interventions that have an existing evidence base for 

20 effectiveness; and 

21 ‘‘(4) criteria designed by the Secretary to en22 sure that the demonstration projects and models will 

23 be carried out in consultation with local and regional 

24 provider organizations, such as community health 


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1 centers, hospital systems, and medical societies rep2 resenting providers of maternity services. 

3 ‘‘(c) DURATION OF DEMONSTRATION PROJECT.— 

4 The demonstration project under subsection (a)(3) shall 

5 begin on January 1, 2018, and end on December 31, 

6 2021. 

7 ‘‘(d) GRANTS FOR EVALUATION AND MONITORING.— 

8 The Secretary may make grants to States and health care 

9 providers participating in the demonstration project under 

10 subsection (a)(3) for the purpose of collecting data nec11 essary for the evaluation and monitoring of such project. 

12 ‘‘(e) REPORTS.— 

13 ‘‘(1) STATE REPORTS.—Each State that par14 ticipates in the demonstration project under sub15 section (a)(3) shall report to the Secretary, in a 

16 time, form, and manner specified by the Secretary, 

17 the data necessary to— 

18 ‘‘(A) monitor the— 

19 ‘‘(i) outcomes of the project; 

20 ‘‘(ii) costs of the project; and 

21 ‘‘(iii) quality of maternity care pro22 vided under the project; and 

23 ‘‘(B) evaluate the rationale for the selec24 tion of the items and services included in any 


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1 bundled payment made by the State under the 

2 project. 

3 ‘‘(2) FINAL REPORT.—Not later than December 

4 31, 2022, the Secretary shall submit to Congress a 

5 report on the results of the demonstration project 

6 under subsection (a)(3).’’. 

Æ 


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