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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6437 Introduced in House (IH)]

111th CONGRESS
  2d Session
                                H. R. 6437

 To amend title XIX of the Social Security Act to improve the quality, 
  health outcomes, and value of maternity care under the Medicaid and 
   CHIP programs by developing a maternity care quality measurement 
 program, identifying payment mechanism improvements, and identifying 
           essential evidence-based maternity care services.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                           November 18, 2010

Mr. Engel (for himself and Mrs. Myrick) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
 To amend title XIX of the Social Security Act to improve the quality, 
  health outcomes, and value of maternity care under the Medicaid and 
   CHIP programs by developing a maternity care quality measurement 
 program, identifying payment mechanism improvements, and identifying 
           essential evidence-based maternity care services.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Partnering to Improve Maternity Care 
Quality Act of 2010''.

SEC. 2. QUALITY MEASURES FOR MATERNITY CARE UNDER MEDICAID AND CHIP.

    Title XIX of the Social Security Act is amended by inserting after 
section 1139B the following new section:

``SEC. 1139C. MATERNITY CARE QUALITY MEASUREMENT.

    ``(a) In General.--The Secretary shall develop a maternity care 
quality measurement program for care provided to childbearing women and 
newborns for use by--
            ``(1) a State in administering a State plan under title XIX 
        or a State Child Health Plan under title XXI;
            ``(2) health insurance issuers (as such term is defined in 
        section 2791 of the Public Health Service Act (42 U.S.C. 300gg-
        91)) and managed care entities that enter into contracts with 
        States for the purpose of administering such plans; and
            ``(3) providers of items and services (including 
        accountable care organizations) with respect to items and 
        services provided under such plans.
    ``(b) Identification of an Initial Set of Maternity Care Quality 
Measures.--
            ``(1) In general.--Not later than January 1, 2013, the 
        Secretary shall identify, and publish, from maternity care 
        quality measures endorsed under section 1890(b)(2), an initial 
        core set of maternity care quality measures for use in data 
        collection and reporting by--
                    ``(A) a State in administering a State plan under 
                title XIX or a State Child Health Plan under title XXI;
                    ``(B) health insurance issuers (as such term is 
                defined in section 2791 of the Public Health Service 
                Act (42 U.S.C. 300gg-91)) and managed care entities 
                that enter into contracts with States for the purpose 
                of administering such plans; and
                    ``(C) providers of items and services (including 
                accountable care organizations) with respect to items 
                and services provided under such plans.
            ``(2) Consultation and public comment.--Not later than 
        January 1, 2012, the Secretary shall--
                    ``(A) solicit public comment on a recommended 
                initial core set of maternity care quality measures; 
                and
                    ``(B) consult with stakeholders identified in 
                subsection (i)(1) regarding such measures.
    ``(c) Development of Additional Quality Measures.--
            ``(1) Contracts with qualified entities.--Not later than 
        the end of the 6-month period beginning on the date the 
        Secretary publishes the initial measures under subsection 
        (b)(1), the Secretary, acting through the Agency for Healthcare 
        Research and Quality, in consultation with the Centers for 
        Medicare & Medicaid Services, shall enter into grants, 
        contracts, or intergovernmental agreements with qualified 
        measure development entities for the purpose of developing, 
        testing, and validating maternity care quality measures in 
        areas that are not adequately covered by the measures 
        identified under subsection (b)(1).
            ``(2) Qualified measure development entity defined.--For 
        purposes of this subsection, the term `qualified measure 
        development entity' means an entity that--
                    ``(A) has demonstrated expertise and capacity in 
                the development and testing of quality measures;
                    ``(B) has adopted procedures for quality measure 
                development that ensure the inclusion of--
                            ``(i) the views of the individuals and 
                        entities who are identified in subsection 
                        (d)(2)(E) and whose performance will be 
                        assessed by the measures; and
                            ``(ii) the views of other individuals and 
                        entities (including patients, consumers, and 
                        health care purchasers) who will use the data 
                        generated as a result of the use of the quality 
                        measures;
                    ``(C) for the purpose of ensuring that the quality 
                measures developed under this subsection meet the 
                requirements to be considered for endorsement under 
                section 1890(b)(2), has provided assurances to the 
                Secretary that the measure development entity will 
                collaborate with--
                            ``(i) the Secretary;
                            ``(ii) the consensus-based entity with a 
                        contract under section 1890(a)(1); and
                            ``(iii) stakeholders (including those 
                        stakeholders identified in subsection (i)(1)), 
                        as practicable;
                    ``(D) has transparent policies regarding governance 
                and conflicts of interest; and
                    ``(E) submits an application to the Secretary at 
                such time, and in such form and manner, as the 
                Secretary may require.
            ``(3) Emeasures.--
                    ``(A) In general.--A qualified measure development 
                entity with a grant, contract, or intergovernmental 
                agreement under paragraph (1), in developing quality 
                measures, shall use the measure-authoring tool of the 
                consensus-based entity with a contract under section 
                1890(a)(1) to create eMeasures that make use of and 
                build upon the quality dataset developed under 
                subsection (g).
                    ``(B) Emeasure defined.--For purposes of this 
                paragraph, the term `eMeasure' means a measure for 
                which measurement data (including clinical data) will 
                be collected electronically, including through the use 
                of electronic health records and other electronic data 
                sources.
            ``(4) Endorsement.--Any maternity care quality measures 
        developed under this subsection by a qualified measure 
        development entity shall be submitted by the qualified measure 
        development entity to the consensus-based entity with a 
        contract under section 1890(a)(1) to be considered for 
        endorsement under section 1890(b)(2).
    ``(d) Types of Measures.--
            ``(1) In general.--The maternity quality measures 
        identified under subsection (b) and the measures developed 
        under subsection (c) shall--
                    ``(A) be evidence-based and, as appropriate, risk-
                adjusted; and
                    ``(B) include a balance of each of the types of 
                measures listed in paragraph (2).
            ``(2) List of types of measures.--The measures listed in 
        this paragraph are the following:
                    ``(A) Measures of the process, experience, 
                efficiency, and outcomes of maternity care, including 
                postpartum outcomes.
                    ``(B) Measures that apply to--
                            ``(i) women and newborns who are healthy 
                        and at low risk, including measures of 
                        appropriately low-intervention, physiologic 
                        birth in low-risk women; and
                            ``(ii) women and newborns at higher risk.
                    ``(C) Measures that apply to--
                            ``(i) childbearing women; and
                            ``(ii) newborns.
                    ``(D) Measures that apply to care during--
                            ``(i) pregnancy;
                            ``(ii) intrapartum period; and
                            ``(iii) the postpartum period.
                    ``(E) Measures that apply to--
                            ``(i) clinicians and clinician groups;
                            ``(ii) facilities;
                            ``(iii) health plans; and
                            ``(iv) accountable care organizations.
                    ``(F) Measurement of--
                            ``(i) disparities;
                            ``(ii) care coordination; and
                            ``(iii) shared decision making.
    ``(e) Maternity Consumer Assessment of Healthcare Providers and 
Systems Surveys.--
            ``(1) Adaption of surveys.--Not later than January 1, 2014, 
        for the purpose of measuring the care experiences of 
        childbearing women and newborns, the Agency for Healthcare 
        Research and Quality shall adapt the Consumer Assessment of 
        Healthcare Providers and Systems program surveys of--
                    ``(A) providers;
                    ``(B) facilities; and
                    ``(C) health plans.
            ``(2) Surveys must be effective.--The Agency for Healthcare 
        Research and Quality shall ensure that the surveys adapted 
        under paragraph (1) are effective in measuring aspects of care 
        that childbearing women and newborns experience, including 
        aspects related to--
                    ``(A) various care settings;
                    ``(B) various types of caregivers;
                    ``(C) considerations relating to pain;
                    ``(D) the use of medications;
                    ``(E) shared decision making--
                            ``(i) during pregnancy;
                            ``(ii) in the intrapartum period; and
                            ``(iii) in the postpartum period; and
                    ``(F) the provision of information, emotional 
                support, and comfort measures during the intrapartum 
                period.
            ``(3) Languages.--The surveys adapted under paragraph (1) 
        shall be available in English and Spanish.
            ``(4) Endorsement.--The Agency for Healthcare Research and 
        Quality shall submit any Consumer Assessment of Healthcare 
        Providers and Systems surveys adapted under this subsection to 
        the consensus-based entity with a contract under section 
        1890(a)(1) to be considered for endorsement under section 
        1890(b)(2).
            ``(5) Consultation.--The adaption of (and process for 
        applying) the surveys under paragraph (1) shall be conducted in 
        consultation with the stakeholders identified in subsection 
        (i)(1).
    ``(f) Measurement Reporting.--
            ``(1) Voluntary reporting.--The Secretary shall encourage 
        voluntary and standardized reporting to the Secretary, using 
        the maternity care quality measures identified under subsection 
        (b) and developed under subsection (c) and the surveys adapted 
        under subsection (e), by--
                    ``(A) clinicians (including physicians, midwives, 
                and clinician groups);
                    ``(B) facilities (including hospitals and 
                freestanding birth centers);
                    ``(C) accountable care organizations; and
                    ``(D) health plans,
        on the performance of such clinicians, facilities, accountable 
        care organizations, or plans.
            ``(2) Standardized format and process.--Not later than 
        January 1, 2013, the Secretary, in consultation with the 
        stakeholders identified under subsection (i)(1), shall--
                    ``(A)(i) develop, validate, and test formats and 
                processes for standardized reporting under paragraph 
                (1)--
                            ``(I) to the clinicians, facilities, 
                        accountable care organizations, health plans, 
                        and State agencies identified in paragraph (3); 
                        and
                            ``(II) to the patients, policymakers, and 
                        payers identified in paragraph (4)(A); and
                    ``(ii) update such formats and processes to 
                incorporate any additional quality measures developed 
                under subsection (c) and any surveys developed under 
                subsection (e); and
                    ``(B) reflect best practices for timely, accurate, 
                effective communications for quality measures, and 
                update such formats and processes as appropriate.
            ``(3) Feedback reports.--
                    ``(A) Clinicians, facilities, accountable care 
                organizations, and health plans.--If the Secretary 
                receives a report from a clinician, facility, 
                accountable care organization, or health plan under 
                paragraph (1), the Secretary shall provide, annually, 
                to such clinician, facility, accountable care 
                organization, or health plan a confidential feedback 
                report that contains quality measure data collected 
                through the report received under paragraph (1), and, 
                if feasible, risk-adjusted benchmarks. Such feedback 
                reports shall be designed and used for the purpose of 
                quality improvement by such clinician, facility, 
                accountable care organization, or plan.
                    ``(B) State agencies.--The Secretary shall provide 
                an annual report to the State agency administering or 
                supervising the administration of a State plan under 
                title XIX or a State Child Health plan under title XXI 
                on the quality of care provided by clinicians, 
                facilities, accountable care organizations, and health 
                plans in such State.
            ``(4) Public availability of data.--
                    ``(A) In general.--Subject to subparagraph (B), the 
                data contained in the reports under paragraph (1) shall 
                be made available to--
                            ``(i) patients to use in maternity care 
                        decision making; and
                            ``(ii) policymakers and purchasers to 
                        assess the quality of maternity care services 
                        provided under titles XIX and XXI.
                    ``(B) Endorsed and valid.--Data reported under this 
                subsection may only be made available under this 
                paragraph, or otherwise made public, if--
                            ``(i) such data are received--
                                    ``(I) from a maternity care quality 
                                measure that is identified under 
                                subsection (b) or developed under 
                                subsection (c); or
                                    ``(II) through the use of a survey 
                                adapted under subsection (e);
                            ``(ii) endorsed without time-limited 
                        qualification under section 1890(b)(2); and
                            ``(iii) the clinician, facility, 
                        accountable care organization, or health plan 
                        that submitted such data has been given an 
                        opportunity to confirm the quality and accuracy 
                        of such data.
    ``(g) Conversion of Currently Endorsed Measures and Creation of 
Initial Quality Dataset To Enable Electronic Health Records To Measure 
the Care of Childbearing Women and Newborns.--
            ``(1) In general.--Not later than January 1, 2012, for the 
        purpose of fostering automated patient-centered longitudinal 
        quality measurement of maternity and newborn care using 
        clinical data, the consensus-based entity with a contract under 
        section 1890(b)(2) shall coordinate--
                    ``(A) the conversion of endorsed measures for the 
                care of childbearing women and newborns to eMeasures 
                (as such term is defined in subsection (c)(3)(B)); and
                    ``(B) the development of an initial quality dataset 
                for use within electronic health records of 
                childbearing women and newborns enrolled in a program 
                administered by a State through State plans under title 
                XIX and State Child Health plans under title XXI for 
                purposes of such eMeasures.
            ``(2) Requirements for emeasure conversion and dataset 
        creation.--The conversion to eMeasures and the dataset creation 
        under paragraph (1) shall, for each quality measure of the care 
        of childbearing women or newborns that the consensus-based 
        entity with a contract under section 1890(b)(2) endorses, use 
        the entity's measure authoring tool to--
                    ``(A) specify standard data elements, quality data 
                elements, and data flow connectors to electronic 
                information;
                    ``(B) specify quality measure logical statements;
                    ``(C) test quality measure validity with an 
                appropriate electronic health record test database;
                    ``(D) finalize eMeasures for export to electronic 
                health record systems; and
                    ``(E) carry out this work in--
                            ``(i) collaboration with the developer or 
                        sponsor of each endorsed measure, who is 
                        responsible, under an agreement with the entity 
                        that endorsed such measure, for updating such 
                        measure; and
                            ``(ii) consultation with the stakeholders 
                        identified in subsection (i)(1).
    ``(h) Measurement Program Reporting.--Not later than January 1, 
2014, and every 2 years thereafter, the Secretary shall submit to the 
Congress and the Medicaid and CHIP Payment and Access Commission a 
report on the status of the maternity care quality measurement program 
under this section, including--
            ``(1) the measured results in maternity care quality;
            ``(2) trends over time in maternity care quality;
            ``(3) the adequacy and use of the set of--
                    ``(A) the quality measures identified under 
                subsection (b);
                    ``(B) the quality measures developed under 
                subsection (c); and
                    ``(C) the surveys adapted under subsection (e);
            ``(4) the adequacy and use of the reporting format under 
        subsection (f)(2);
            ``(5) the adequacy of the quality dataset under subsection 
        (g); and
            ``(6) any recommendations for programmatic and legislative 
        changes needed to improve the quality of care provided to 
        childbearing women and newborns under this title and title XXI, 
        including recommendations for quality reporting by the States.
    ``(i) Stakeholders.--
            ``(1) In general.--The stakeholders identified in this 
        subsection are--
                    ``(A) State Medicaid administrators;
                    ``(B) maternal-fetal medicine specialists;
                    ``(C) obstetrician-gynecologists;
                    ``(D) family physicians;
                    ``(E) certified nurse-midwives;
                    ``(F) certified midwives;
                    ``(G) nurse practitioners;
                    ``(H) nurses;
                    ``(I) neonatologists;
                    ``(J) pediatricians;
                    ``(K) consumers and their advocates;
                    ``(L) health quality measurement experts;
                    ``(M) health quality measure developers;
                    ``(N) representatives from the consensus-based 
                entity with a contract under section 1890(a) of the 
                Social Security Act;
                    ``(O) electronic health record developers and 
                vendors;
                    ``(P) employers and purchasers;
                    ``(Q) health facility and health system leaders; 
                and
                    ``(R) other individuals who are involved in the 
                advancement of evidence-based maternity care quality 
                measures.
            ``(2) Professional organizations.--The stakeholders 
        identified under paragraph (1) may include representatives from 
        professional organizations and specialty societies (such as the 
        American College of Obstetricians and Gynecologists, the 
        American Academy of Family Physicians, the American College of 
        Nurse-Midwives, the Society for Maternal Fetal Medicine, and 
        the Association of Women's Health, Obstetric, and Neonatal 
        Nurses).
    ``(j) Appropriation.--Out of any funds in the Treasury not 
otherwise appropriated, there are appropriated for each of fiscal years 
2011 through 2015, such sums as may be necessary for the purpose of 
carrying out this section. Funds appropriated under this subsection 
shall remain available until expended.''.

SEC. 3. DEMONSTRATION PROJECT TO EVALUATE PAYMENT REFORM IN MATERNITY 
              CARE.

    (a) In General.--The Secretary of Health and Human Services shall 
establish a demonstration project to evaluate the use of alternative 
payment methods under the Medicaid program under title XIX of the 
Social Security Act, for the purpose of--
            (1) improving the quality, value, and outcomes of maternity 
        care by reliably delivering effective care that contributes to 
        improved outcomes; and
            (2) reducing the costs of maternity care for beneficiaries 
        under such program by--
                    (A) delivering effective care;
                    (B) avoiding overuse of care that may cause harm to 
                the beneficiary or a waste of resources, without 
                providing a benefit to the beneficiary; and
                    (C) discouraging the provision of care that lacks 
                an evidence base and is contrary to strong 
                recommendations supported by high quality evidence in 
                clinical practice guidelines from nationally recognized 
                specialty societies and professional organizations.
    (b) Payments.--
            (1) Requirements.--Payments made under the demonstration 
        project under subsection (a) for the provision of medical 
        services shall be adjusted for the health conditions and other 
        characteristics of Medicaid beneficiaries, as determined by the 
        Secretary.
            (2) Allowable payment structures.--Under the demonstration 
        project under subsection (a), the Secretary may evaluate 
        alternative payment methods, including the following:
                    (A) Payments that are defined to cover services for 
                a single episode of care for an individual woman and 
                her newborn, including--
                            (i) all care from the prenatal through the 
                        postpartum period; or
                            (ii) all care received during the 
                        intrapartum period.
                    (B) Payments based on a condition-adjusted 
                capitated rate for a population of women and newborns.
                    (C) Payments that cover multiple providers (such as 
                hospitals, birth centers, physicians, midwives, and 
                nurse practitioners) that would otherwise be paid 
                separately.
                    (D) Payments in the form of ``virtual bundling'', 
                in which providers are paid separately, but the amount 
                of such payments are adjusted so that the total of the 
                individual payments to each provider remains under a 
                total payment budget for the episode of care.
                    (E) Payments to providers (including doulas, and 
                other providers of continuous labor support) and for 
                services (such as shared decision making, breast-
                feeding support programs, and doula services) that may 
                not currently be eligible for direct reimbursement 
                under title XIX of the Social Security Act.
                    (F) Payments that cover multiple services that 
                would otherwise be paid for separately, or that allow 
                greater flexibility as to the type of provider, 
                location of service, or approach to care than would 
                otherwise be permitted, to enable providers to improve 
                outcomes or value.
                    (G) Other payment innovations that are likely to 
                result in improved maternity care quality, outcomes, 
                and value (such as payment of bonuses for improved 
                outcomes or payments for care coordination).
            (3) Evaluation and monitoring.--The Secretary shall also 
        make payments for the purpose of collecting data necessary for 
        the evaluation and monitoring of the demonstration project 
        under this section.
    (c) Scope and Selection of States.--The demonstration project under 
subsection (a) shall be conducted in no more than 8 States, which shall 
be selected by the Secretary based on--
            (1) an application that--
                    (A) is submitted by a entity or consortium that--
                            (i) includes the single State agency under 
                        section 1902(a)(5); and
                            (ii) may include managed care 
                        organizations, integrated health systems, and 
                        accountable care organizations providing 
                        maternity care to Medicaid and CHIP 
                        beneficiaries; and
                    (B) specifies the regions and populations in the 
                State that will be served by the entity or consortium 
                under the demonstration project;
            (2) criteria designed to ensure that, as a whole, the 
        demonstration project is, to the greatest extent possible, 
        representative of the demographic and geographic composition of 
        Medicaid beneficiaries nationally; and
            (3) criteria designed to ensure that multiple payment 
        models are tested through the demonstration project.
    (d) Protections for Beneficiaries.--
            (1) No additional cost sharing.--Under the demonstration 
        project under subsection (a), a Medicaid beneficiary shall not 
        be liable for any cost sharing in excess of the amount of cost 
        sharing that such beneficiary would otherwise be liable for 
        under title XIX of the Social Security Act.
            (2) No reduction in quality.--A provider who provides 
        services to a Medicaid beneficiary under the demonstration 
        project under subsection (a) shall provide services that the 
        provider expects will result in a similar or improved health 
        outcome for such beneficiary, compared with the services such 
        beneficiary would receive under title XIX of the Social 
        Security Act if the beneficiary was not receiving services 
        under the demonstration project.
            (3) No denial of covered services.--In no case may a 
        Medicaid beneficiary be denied maternity and nonmaternity items 
        and services under the demonstration project under subsection 
        (a) than such beneficiary would otherwise receive under title 
        XIX of the Social Security Act.
    (e) Period.--The demonstration project under subsection (a) shall 
begin on January 1, 2012, and shall end on December 31, 2016.
    (f) Reports.--
            (1) State reports.--Each entity or consortium with an 
        application that is approved under subsection (c) that 
        participates in the demonstration project under subsection (a) 
        shall report to the Secretary, in a time, form, and manner 
        specified by the Secretary, the data necessary to--
                    (A) monitor the--
                            (i) health outcomes of participating 
                        beneficiaries;
                            (ii) the costs of the project; and
                            (iii) the quality of maternity care 
                        provided under the project; and
                    (B) evaluate the rationale for the selection of the 
                items and services included in any bundled payment made 
                by the entity or consortium under the project.
            (2) Final report.--Not later than December 31, 2017, the 
        Secretary shall submit to Congress a report containing--
                    (A) the results of the demonstration project under 
                subsection (a);
                    (B) an assessment of the influence of medical 
                liability on the results of such project; and
                    (C) recommendations for changes in Medicaid payment 
                policies to enhance the quality, health outcomes, and 
                value of maternity care provided through the Medicaid 
                program.

SEC. 4. ESSENTIAL SERVICES FOR CHILDBEARING WOMEN AND NEWBORNS.

    (a) Report on Evidence-Based Maternity Care Services.--The 
Secretary of Health and Human Services is authorized to, and shall seek 
to, enter an agreement with the Institute of Medicine of the National 
Academies to develop and, not later than January 1, 2013, publish a 
report that, on the basis of the best available evidence, identifies 
the following:
            (1) Essential services.--The following essential maternity 
        care services:
                    (A) A package of evidence-based maternity care 
                services that the Institute of Medicine identifies as 
                essential for the majority of childbearing women and 
                newborns who are healthy and at low risk for 
                complications during pregnancy, birth, the postpartum 
                period, and the newborn period (the 28-day period 
                beginning on the date of birth).
                    (B) Any additional and differing maternity care 
                services that the Institute of Medicine identifies as 
                essential to women and newborns who are at higher risk 
                than the individuals described under paragraph (1) for 
                complications during pregnancy, birth, the postpartum 
                period, and the newborn period.
                    (C) Any pre- and interconception care services that 
                have been demonstrated to contribute to improved 
                maternal and newborn outcomes.
            (2) Limited value and understudied services.--Maternity 
        care services that are identified by the Institute of Medicine 
        as--
                    (A) being of limited value (including use of a 
                specific service for indications that are not 
                supported); or
                    (B) requiring comparative effectiveness research to 
                clarify the safety and effectiveness of such services.
    (b) Strength of Evidence.--In identifying the essential services 
under subsection (a)(1), the Institute of Medicine shall--
            (1) give priority to maternal care services that are 
        supported for use for specific indications or populations by 
        systematic reviews with high- or moderate-quality evidence and 
        strong recommendations, as determined by a valid assessment 
        system, such as GRADE (Grading of Recommendations Assessment, 
        Development and Evaluation); and
            (2) clearly indicate if a service that is recommended as 
        essential is based on lower quality evidence or weaker 
        recommendations than the levels described under paragraph (1).
    (c) Consultative Process.--
            (1) In general.--The Institute of Medicine shall develop 
        the report under subsection (a) in consultation with a 
        multistakeholder panel that includes representatives of--
                    (A) clinicians with expertise in--
                            (i) obstetrics;
                            (ii) family medicine;
                            (iii) pediatrics;
                            (iv) midwifery;
                            (v) nursing;
                            (vi) maternal fetal medicine;
                            (vii) genetics;
                            (viii) anesthesia;
                            (ix) substance abuse;
                            (x) reproductive endocrinology;
                            (xi) mental health;
                            (xii) infectious disease; and
                            (xiii) interconception care;
                    (B) consumers and their advocates;
                    (C) payers and purchasers; and
                    (D) research methodology experts.
            (2) Professional organizations.--The representatives under 
        paragraph (1) may include representatives from professional 
        organizations and specialty societies (such as the American 
        College of Obstetricians and Gynecologists, the American 
        Academy of Family Physicians, the American College of Nurse-
        Midwives, the Society for Maternal Fetal Medicine, and the 
        Association of Women's Health, Obstetric, and Neonatal Nurses).
    (d) Definition of Maternal Care Services.--For purposes of the 
report under subsection (a), the term ``maternity care services'' shall 
include--
            (1) services related to the confirmation of pregnancy and 
        preconception, prenatal, intrapartum, postpartum, newborn, and 
        interconception care;
            (2) newborn care services that are incidental to 
        interconception care;
            (3) mental health and substance abuse services; and
            (4) support services (such as language translation and care 
        coordination).
    (e) Sense of Congress.--It is the sense of Congress that the 
Administrator of the Centers for Medicare & Medicaid Services and the 
directors of State Medicaid agencies should ensure that the services 
available to childbearing women and newborns under the Medicaid program 
in each State are well-aligned with the essential maternity care 
services identified in subsection (a)(1).
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