II 

117TH CONGRESS 

1ST SESSION S. 893 

To support the use of technology in maternal health care. 

IN THE SENATE OF THE UNITED STATES 

MARCH 23, 2021 

Mr. MENENDEZ (for himself and Mr. SULLIVAN) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To support the use of technology in maternal health care. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Tech to Save Moms 

5 Act’’. 

6 SEC. 2. INTEGRATED TELEHEALTH MODELS IN MATERNITY 

7 CARE SERVICES. 

8 (a) IN GENERAL.—Section 1115A(b)(2)(B) of the 

9 Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amend10 ed by adding at the end the following: 


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1 ‘‘(xxviii) Focusing on title XIX, pro2 viding for the adoption of and use of tele3 health tools that allow for screening, moni4 toring, and management of common health 

5 complications with respect to an individual 

6 receiving medical assistance during such 

7 individual’s pregnancy and for not more 

8 than a 1-year period beginning on the last 

9 day of the pregnancy.’’. 

10 (b) EFFECTIVE DATE.—The amendment made by 

11 subsection (a) shall take effect 1 year after the date of 

12 enactment of this Act. 

13 SEC. 3. GRANTS TO EXPAND THE USE OF TECHNOLOGY-EN14 ABLED COLLABORATIVE LEARNING AND CA15 PACITY MODELS FOR PREGNANT AND 

16 POSTPARTUM INDIVIDUALS. 

17 Title III of the Public Health Service Act is amended 

18 by inserting after section 330N (42 U.S.C. 254c–19) the 

19 following: 

20 ‘‘SEC. 330O. EXPANDING CAPACITY FOR MATERNAL 

21 HEALTH OUTCOMES. 

22 ‘‘(a) ESTABLISHMENT.—Beginning not later than 1 

23 year after the date of enactment of this section, the Sec24 retary shall award grants to eligible entities to evaluate, 

25 develop, and expand the use of technology-enabled collaboVerDate Sep 11 2014 00:58 Apr 13, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S893.IS S893

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1 rative learning and capacity building models and improve 

2 maternal health outcomes— 

3 ‘‘(1) in health professional shortage areas; 

4 ‘‘(2) in areas with high rates of maternal mor5 tality and severe maternal morbidity; 

6 ‘‘(3) in areas with significant racial and ethnic 

7 disparities in maternal health outcomes; and 

8 ‘‘(4) for medically underserved populations and 

9 American Indians and Alaska Natives, including In10 dian Tribes, Tribal organizations, and Urban Indian 

11 organizations. 

12 ‘‘(b) USE OF FUNDS.— 

13 ‘‘(1) REQUIRED USES.—Recipients of grants 

14 under this section shall use the grants to— 

15 ‘‘(A) train maternal health care providers, 

16 students, and other similar professionals 

17 through models that include— 

18 ‘‘(i) methods to increase safety and 

19 health care quality; 

20 ‘‘(ii) methods to address implicit bias, 

21 racism, and discrimination; 

22 ‘‘(iii) best practices in screening for 

23 maternal mental health conditions and 

24 substance use disorders and, as needed, 


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1 evaluating and treating such conditions 

2 and disorders; 

3 ‘‘(iv) training on best practices in ma4 ternity care for pregnant and postpartum 

5 individuals during the COVID–19 public 

6 health emergency or future public health 

7 emergencies; 

8 ‘‘(v) methods to screen for social de9 terminants of maternal health risks in the 

10 prenatal and postpartum; and 

11 ‘‘(vi) the use of remote patient moni12 toring tools for pregnancy-related com13 plications described in section 

14 1115A(b)(2)(B)(xxviii); 

15 ‘‘(B) evaluate and collect information on 

16 the affect of such models on— 

17 ‘‘(i) access to and quality of care; 

18 ‘‘(ii) outcomes with respect to the 

19 health of an individual; 

20 ‘‘(iii) the experience of individuals who 

21 receive pregnancy-related health care; 

22 ‘‘(C) develop qualitative and quantitative 

23 measures to identify best practices for the ex24 pansion and use of such models; 


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1 ‘‘(D) study the effect of such models on 

2 patient outcomes and maternity care providers; 

3 and 

4 ‘‘(E) conduct any other activity, as deter5 mined by the Secretary. 

6 ‘‘(2) PERMISSIBLE USES.—Recipients of grants 

7 under this section may use grants to support— 

8 ‘‘(A) the use and expansion of technology9 enabled collaborative learning and capacity 

10 building models, including hardware and soft11 ware that— 

12 ‘‘(i) enables distance learning and 

13 technical support; and 

14 ‘‘(ii) supports the secure exchange of 

15 electronic health information; and 

16 ‘‘(B) maternity care providers, students, 

17 and other similar professionals in the provision 

18 of maternity care through such models. 

19 ‘‘(c) APPLICATION.— 

20 ‘‘(1) IN GENERAL.—An eligible entity seeking a 

21 grant under subsection (a) shall submit to the Sec22 retary an application, at such time, in such manner, 

23 and containing such information as the Secretary 

24 may require. 


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1 ‘‘(2) ASSURANCE.—An application under para2 graph (1) shall include an assurance that such entity 

3 shall collect information on, and assess the affect of, 

4 the use of technology-enabled collaborative learning 

5 and capacity building models, including with respect 

6 to— 

7 ‘‘(A) maternal health outcomes; 

8 ‘‘(B) access to maternal health care serv9 ices; 

10 ‘‘(C) quality of maternal health care; and 

11 ‘‘(D) retention of maternity care providers 

12 serving areas and populations described in sub13 section (a). 

14 ‘‘(d) LIMITATIONS.— 

15 ‘‘(1) NUMBER.—Each entity receiving a grant 

16 under this section may receive not more than 1 such 

17 grant. 

18 ‘‘(2) DURATION.—A grant awarded under this 

19 section shall be for a 5-year period. 

20 ‘‘(e) ACCESS TO BROADBAND.—In administering 

21 grants under this section, the Secretary may coordinate 

22 with other agencies to ensure that funding opportunities 

23 are available to support access to reliable, high-speed 

24 internet for grantees. 


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1 ‘‘(f) TECHNICAL ASSISTANCE.—The Secretary shall 

2 provide (either directly or by contract) technical assistance 

3 to eligible entities, including recipients of grants under 

4 subsection (a), on the development, use, and sustainability 

5 of technology-enabled collaborative learning and capacity 

6 building models to expand access to maternal health care 

7 services provided by such entities, including— 

8 ‘‘(1) in health professional shortage areas; 

9 ‘‘(2) in areas with high rates of maternal mor10 tality and severe maternal morbidity or significant 

11 racial and ethnic disparities in maternal health out12 comes; and 

13 ‘‘(3) for medically underserved populations or 

14 American Indians and Alaska Natives. 

15 ‘‘(g) RESEARCH AND EVALUATION.—The Secretary, 

16 in consultation with experts, shall develop a strategic plan 

17 to research and evaluate the evidence for such models. 

18 ‘‘(h) REPORTING.— 

19 ‘‘(1) ELIGIBLE ENTITIES.—An eligible entity 

20 that receives a grant under subsection (a) shall sub21 mit to the Secretary a report, at such time, in such 

22 manner, and containing such information as the Sec23 retary may require. 

24 ‘‘(2) SECRETARY.—Not later than 4 years after 

25 the date of enactment of this section, the Secretary 


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1 shall submit to Congress, and make available on the 

2 website of the Department of Health and Human 

3 Services, a report that includes— 

4 ‘‘(A) a description of grants awarded 

5 under subsection (a) and the purpose and 

6 amounts of such grants; 

7 ‘‘(B) a summary of— 

8 ‘‘(i) the evaluations conducted under 

9 subsection (b)(1)(B); 

10 ‘‘(ii) any technical assistance provided 

11 under subsection (f); and 

12 ‘‘(iii) the activities conducted under a 

13 grant awarded under subsection (a); and 

14 ‘‘(C) a description of any significant find15 ings with respect to— 

16 ‘‘(i) patient outcomes; and 

17 ‘‘(ii) best practices for expanding, 

18 using, or evaluating technology-enabled col19 laborative learning and capacity building 

20 models. 

21 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 

22 authorized to be appropriated to carry out this section, 

23 $6,000,000 for each of fiscal years 2022 through 2026. 

24 ‘‘(j) DEFINITIONS.—In this section: 

25 ‘‘(1) ELIGIBLE ENTITY.— 


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1 ‘‘(A) IN GENERAL.—The term ‘eligible en2 tity’ means an entity that provides, or supports 

3 the provision of, maternal health care services 

4 or other evidence-based services for pregnant 

5 and postpartum individuals— 

6 ‘‘(i) in health professional shortage 

7 areas; 

8 ‘‘(ii) in areas with high rates of ad9 verse maternal health outcomes or signifi10 cant racial and ethnic disparities in mater11 nal health outcomes; or 

12 ‘‘(iii) who are— 

13 ‘‘(I) members of medically under14 served populations; or 

15 ‘‘(II) American Indians and Alas16 ka Natives, including Indian Tribes, 

17 Tribal organizations, and urban In18 dian organizations. 

19 ‘‘(B) INCLUSIONS.—An eligible entity may 

20 include entities that lead, or are capable of 

21 leading, a technology-enabled collaborative 

22 learning and capacity building model. 

23 ‘‘(2) HEALTH PROFESSIONAL SHORTAGE

24 AREA.—The term ‘health professional shortage area’ 


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1 means a health professional shortage area des2 ignated under section 332. 

3 ‘‘(3) INDIAN TRIBE.—The term ‘Indian Tribe’ 

4 has the meaning given such term in section 4 of the 

5 Indian Self-Determination and Education Assistance 

6 Act. 

7 ‘‘(4) MATERNAL MORTALITY.—The term ‘ma8 ternal mortality’ means a death occurring during or 

9 within 1-year period after pregnancy caused by preg10 nancy-related or childbirth complications, including a 

11 suicide, overdose, or other death resulting from a 

12 mental health or substance use disorder attributed 

13 to or aggravated by pregnancy or childbirth com14 plications. 

15 ‘‘(5) MEDICALLY UNDERSERVED POPU16 LATION.—The term ‘medically underserved popu17 lation’ has the meaning given such term in section 

18 330(b)(3). 

19 ‘‘(6) POSTPARTUM.—The term ‘postpartum’ 

20 means the 1-year period beginning on the last date 

21 of an individual’s pregnancy. 

22 ‘‘(7) SEVERE MATERNAL MORBIDITY.—The 

23 term ‘severe maternal morbidity’ means a health 

24 condition, including a mental health or substance 

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1 nancy or childbirth that results in significant short2 term or long-term consequences to the health of the 

3 individual who was pregnant. 

4 ‘‘(8) TECHNOLOGY-ENABLED COLLABORATIVE

5 LEARNING AND CAPACITY BUILDING MODEL.—The 

6 term ‘technology-enabled collaborative learning and 

7 capacity building model’ means a distance health 

8 education model that connects health care profes9 sionals, and other specialists, through simultaneous 

10 interactive videoconferencing for the purpose of fa11 cilitating case-based learning, disseminating best 

12 practices, and evaluating outcomes in the context of 

13 maternal health care. 

14 ‘‘(9) TRIBAL ORGANIZATION.—The term ‘Tribal 

15 organization’ has the meaning given such term in 

16 section 4 of the Indian Self-Determination and Edu17 cation Assistance Act. 

18 ‘‘(10) URBAN INDIAN ORGANIZATION.—The 

19 term ‘urban Indian organization’ has the meaning 

20 given such term in section 4 of the Indian Health 

21 Care Improvement Act.’’. 


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1 SEC. 4. GRANTS TO PROMOTE EQUITY IN MATERNAL 

2 HEALTH OUTCOMES THROUGH DIGITAL 

3 TOOLS. 

4 (a) IN GENERAL.—Beginning not later than 1 year 

5 after the date of the enactment of this Act, the Secretary 

6 of Health and Human Services shall award grants to eligi7 ble entities to reduce racial and ethnic disparities in ma8 ternal health outcomes by increasing access to digital tools 

9 related to maternal health care, including provider-facing 

10 technologies, such as early warning systems and clinical 

11 decision support mechanisms. 

12 (b) APPLICATIONS.—To be eligible to receive a grant 

13 under this section, an eligible entity shall submit to the 

14 Secretary an application at such time, in such manner, 

15 and containing such information as the Secretary may re16 quire. 

17 (c) PRIORITIZATION.—In awarding grants under this 

18 section, the Secretary shall prioritize an eligible entity— 

19 (1) in an area with high rates of adverse mater20 nal health outcomes or significant racial and ethnic 

21 disparities in maternal health outcomes; 

22 (2) in a health professional shortage area des23 ignated under section 332 of the Public Health Serv24 ice Act (42 U.S.C. 254e); and 


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1 (3) that promotes technology that addresses ra2 cial and ethnic disparities in maternal health out3 comes. 

4 (d) LIMITATIONS.— 

5 (1) NUMBER.—Each entity receiving a grant 

6 under this section may receive not more than 1 such 

7 grant. 

8 (2) DURATION.—A grant awarded under this 

9 section shall be for a 5-year period. 

10 (e) TECHNICAL ASSISTANCE.—The Secretary shall 

11 provide technical assistance to an eligible entity on the de12 velopment, use, evaluation, and post-grant sustainability 

13 of digital tools for purposes of promoting equity in mater14 nal health outcomes. 

15 (f) REPORTING.— 

16 (1) ELIGIBLE ENTITIES.—An eligible entity 

17 that receives a grant under subsection (a) shall sub18 mit to the Secretary a report, at such time, in such 

19 manner, and containing such information as the Sec20 retary may require. 

21 (2) SECRETARY.—Not later than 4 years after 

22 the date of the enactment of this Act, the Secretary 

23 shall submit to Congress a report that includes— 

24 (A) an evaluation on the effectiveness of 

25 grants awarded under this section to improve 


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1 health outcomes for pregnant and postpartum 

2 individuals from racial and ethnic minority 

3 groups; 

4 (B) recommendations on new grant pro5 grams that promote the use of technology to 

6 improve such maternal health outcomes; and 

7 (C) recommendations with respect to— 

8 (i) technology-based privacy and secu9 rity safeguards in maternal health care; 

10 (ii) reimbursement rates for maternal 

11 telehealth services; 

12 (iii) the use of digital tools to analyze 

13 large data sets to identify potential preg14 nancy-related complications; 

15 (iv) barriers that prevent maternity 

16 care providers from providing telehealth 

17 services across States; 

18 (v) the use of consumer digital tools 

19 such as mobile phone applications, patient 

20 portals, and wearable technologies to im21 prove maternal health outcomes; 

22 (vi) barriers that prevent access to 

23 telehealth services, including a lack of ac24 cess to reliable, high-speed internet or elec25 tronic devices; 


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1 (vii) barriers to data sharing between 

2 the Special Supplemental Nutrition Pro3 gram for Women, Infants, and Children 

4 program and maternity care providers, and 

5 recommendations for addressing such bar6 riers; and 

7 (viii) lessons learned from expanded 

8 access to telehealth related to maternity 

9 care during the COVID–19 public health 

10 emergency. 

11 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section 

13 $6,000,000 for each of fiscal years 2022 through 2026. 

14 SEC. 5. REPORT ON THE USE OF TECHNOLOGY IN MATER15 NITY CARE. 

16 (a) IN GENERAL.—Not later than 60 days after the 

17 date of enactment of this Act, the Secretary of Health and 

18 Human Services shall seek to enter an agreement with the 

19 National Academies of Sciences, Engineering, and Medi20 cine (referred to in this Act as the ‘‘National Academies’’) 

21 under which the National Academies shall conduct a study 

22 on the use of technology and patient monitoring devices 

23 in maternity care. 


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1 (b) CONTENT.—The agreement entered into pursu2 ant to subsection (a) shall provide for the study of the 

3 following: 

4 (1) The use of innovative technology (including 

5 artificial intelligence) in maternal health care, in6 cluding the extent to which such technology has af7 fected racial or ethnic biases in maternal health 

8 care. 

9 (2) The use of patient monitoring devices (in10 cluding pulse oximeter devices) in maternal health 

11 care, including the extent to which such devices have 

12 affected racial or ethnic biases in maternal health 

13 care. 

14 (3) Best practices for reducing and preventing 

15 racial or ethnic biases in the use of innovative tech16 nology and patient monitoring devices in maternity 

17 care. 

18 (4) Best practices in the use of innovative tech19 nology and patient monitoring devices for pregnant 

20 and postpartum individuals from racial and ethnic 

21 minority groups. 

22 (5) Best practices with respect to privacy and 

23 security safeguards in such use. 

24 (c) REPORT.—The agreement under subsection (a) 

25 shall direct the National Academies to complete the study 


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1 under this section, and transmit to Congress a report on 

2 the results of the study, not later than 2 years after the 

3 date of enactment of this Act. 

4 SEC. 6. DEFINITIONS. 

5 In this Act: 

6 (1) MATERNITY CARE PROVIDER.—The term 

7 ‘‘maternity care provider’’ means a health care pro8 vider who— 

9 (A) is a physician, physician assistant, 

10 midwife who meets at a minimum the inter11 national definition of the midwife and global 

12 standards for midwifery education as estab13 lished by the International Confederation of 

14 Midwives, nurse practitioner, or clinical nurse 

15 specialist; and 

16 (B) has a focus on maternal or perinatal 

17 health. 

18 (2) POSTPARTUM AND POSTPARTUM PERIOD.— 

19 The terms ‘‘postpartum’’ and ‘‘postpartum period’’ 

20 refer to the 1-year period beginning on the last day 

21 of the pregnancy of an individual. 

22 (3) RACIAL AND ETHNIC MINORITY GROUP.— 

23 The term ‘‘racial and ethnic minority group’’ has the 

24 meaning given such term in section 1707(g)(1) of 


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1 the Public Health Service Act (42 U.S.C. 300u– 

2 6(g)(1)). 

Æ 


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