II 

117TH CONGRESS 

1ST SESSION S. 334 

To establish an alternative payment model demonstration project for maternity care provided to pregnant and postpartum individuals under State 

Medicaid and CHIP programs, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 22, 2021 

Mr. CASEY (for himself, Mr. MENENDEZ, and Mr. BOOKER) introduced the 

following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To establish an alternative payment model demonstration 

project for maternity care provided to pregnant and 

postpartum individuals under State Medicaid and CHIP 

programs, and for other purposes. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘IMPACT to Save 

5 Moms Act’’. 


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1 SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL 

2 DEMONSTRATION PROJECT. 

3 (a) IN GENERAL.—For the period of fiscal years 

4 2022 through 2026, the Secretary of Health and Human 

5 Services (referred to in this section as the ‘‘Secretary’’), 

6 acting through the Administrator of the Centers for Medi7 care & Medicaid Services, shall establish and implement, 

8 in accordance with the requirements of this section, a 

9 demonstration project, to be known as the Perinatal Care 

10 Alternative Payment Model Demonstration Project (re11 ferred to in this section as the ‘‘Demonstration Project’’), 

12 for purposes of allowing States to test payment models 

13 under their State plans under title XIX of the Social Secu14 rity Act (42 U.S.C. 1396 et seq.) and State child health 

15 plans under title XXI of such Act (42 U.S.C. 1397aa et 

16 seq.) with respect to maternity care provided to pregnant 

17 and postpartum individuals enrolled in such State plans 

18 and State child health plans. 

19 (b) COORDINATION.—In establishing the Demonstra20 tion Project, the Secretary shall coordinate with stake21 holders such as— 

22 (1) State Medicaid programs; 

23 (2) maternity care providers and organizations 

24 representing maternity care providers; 


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1 (3) relevant organizations representing patients, 

2 with a particular focus on patients from racial and 

3 ethnic minority groups; 

4 (4) relevant community-based organizations, 

5 particularly organizations that seek to improve ma6 ternal health outcomes for pregnant and postpartum 

7 individuals from racial and ethnic minority groups; 

8 (5) perinatal health workers; 

9 (6) relevant health insurance issuers; 

10 (7) hospitals, health systems, midwifery prac11 tices, freestanding birth centers (as such term is de12 fined in paragraph (3)(B) of section 1905(l) of the 

13 Social Security Act (42 U.S.C. 1396d(l)), federally 

14 qualified health centers (as such term is defined in 

15 paragraph (2)(B) of such section), and rural health 

16 clinics (as such term is defined in section 1861(aa) 

17 of such Act (42 U.S.C. 1395x(aa))); 

18 (8) researchers and policy experts in fields re19 lated to maternity care payment models; and 

20 (9) any other stakeholders as the Secretary de21 termines appropriate, with a particular focus on 

22 stakeholders from racial and ethnic minority groups. 

23 (c) CONSIDERATIONS.—In establishing the Dem24 onstration Project, the Secretary shall consider any alter25 native payment model that— 


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1 (1) is designed to improve maternal health out2 comes for racial and ethnic groups with dispropor3 tionate rates of adverse maternal health outcomes; 

4 (2) includes methods for stratifying patients by 

5 pregnancy risk level and, as appropriate, adjusting 

6 payments under such model to take into account 

7 pregnancy risk level; 

8 (3) establishes evidence-based quality metrics 

9 for such payments; 

10 (4) includes consideration of non-hospital birth 

11 settings such as freestanding birth centers (as so de12 fined); 

13 (5) includes consideration of social deter14 minants of maternal health; or 

15 (6) includes diverse maternity care teams that 

16 include— 

17 (A) maternity care providers, mental and 

18 behavioral health care providers acting in ac19 cordance with State law, registered dietitians or 

20 nutrition professionals (as such term is defined 

21 in section 1861(vv)(2) of the Social Security 

22 Act (42 U.S.C. 1395x(vv)(2))), and Inter23 national Board Certified Lactation Consult24 ants— 


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1 (i) from racially, ethnically, and pro2 fessionally diverse backgrounds; 

3 (ii) with experience practicing in ra4 cially and ethnically diverse communities; 

5 or 

6 (iii) who have undergone training on 

7 implicit bias and racism; and 

8 (B) perinatal health workers. 

9 (d) ELIGIBILITY.—To be eligible to participate in the 

10 Demonstration Project, a State shall submit an applica11 tion to the Secretary at such time, in such manner, and 

12 containing such information as the Secretary may require. 

13 (e) EVALUATION.—The Secretary shall conduct an 

14 evaluation of the Demonstration Project to determine the 

15 impact of the Demonstration Project on— 

16 (1) maternal health outcomes, with data strati17 fied by race, ethnicity, socioeconomic indicators, and 

18 any other factors as the Secretary determines appro19 priate; 

20 (2) spending on maternity care by States par21 ticipating in the Demonstration Project; 

22 (3) to the extent practicable, qualitative and 

23 quantitative measures of patient experience; and 

24 (4) any other areas of assessment that the Sec25 retary determines relevant. 


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1 (f) REPORT.—Not later than 1 year after the comple2 tion or termination date of the Demonstration Project, the 

3 Secretary shall submit to the Congress, and make publicly 

4 available, a report containing— 

5 (1) the results of any evaluation conducted 

6 under subsection (e); and 

7 (2) a recommendation regarding whether the 

8 Demonstration Project should be continued after fis9 cal year 2026 and expanded on a national basis. 

10 (g) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated such sums as are nec12 essary to carry out this section. 

13 (h) DEFINITIONS.—In this section: 

14 (1) ALTERNATIVE PAYMENT MODEL.—The 

15 term ‘‘alternative payment model’’ has the meaning 

16 given such term in section 1833(z)(3)(C) of the So17 cial Security Act (42 U.S.C. 1395l(z)(3)(C)). 

18 (2) PERINATAL.—The term ‘‘perinatal’’ means 

19 the period beginning on the day an individual be20 comes pregnant and ending on the last day of the 

21 1-year period beginning on the last day of such indi22 vidual’s pregnancy. 

23 (3) RACIAL AND ETHNIC MINORITY GROUP.— 

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

25 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)). 

3 SEC. 3. MACPAC REPORT. 

4 Not later than 2 years after the date of the enact5 ment of this Act, the Medicaid and CHIP Payment and 

6 Access Commission shall publish a report on issues relat7 ing to the continuity of coverage under State plans under 

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

9 seq.) and State child health plans under title XXI of such 

10 Act (42 U.S.C. 1397aa et seq.) for pregnant and 

11 postpartum individuals. Such report shall, at a minimum, 

12 include the following: 

13 (1) An assessment of any existing policies 

14 under such State plans and such State child health 

15 plans regarding presumptive eligibility for pregnant 

16 individuals while their application for enrollment in 

17 such a State plan or such a State child health plan 

18 is being processed. 

19 (2) An assessment of any existing policies 

20 under such State plans and such State child health 

21 plans regarding measures to ensure continuity of 

22 coverage under such a State plan or such a State 

23 child health plan for pregnant and postpartum indi24 viduals, including such individuals who need to 

25 change their health insurance coverage during their 


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1 pregnancy or the postpartum period following their 

2 pregnancy. 

3 (3) An assessment of any existing policies 

4 under such State plans and such State child health 

5 plans regarding measures to automatically reenroll 

6 individuals who are eligible to enroll under such a 

7 State plan or such a State child health plan as a 

8 parent. 

9 (4) If determined appropriate by the Commis10 sion, any recommendations for the Department of 

11 Health and Human Services, or such State plans 

12 and such State child health plans, to ensure con13 tinuity of coverage under such a State plan or such 

14 a State child health plan for pregnant and 

15 postpartum individuals. 

Æ 


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