I 

118TH CONGRESS 

1ST SESSION H. R. 2480 

To direct the Secretary of Health and Human Services to issue guidance 

on coverage under the Medicaid program under title XIX of the Social 

Security Act of certain pelvic health services furnished during the 

postpartum period, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 6, 2023 

Mr. BACON (for himself, Ms. BLUNT ROCHESTER, Ms. SEWELL, Mrs. 

GONZA ́LEZ-COLO ́N, Ms. WILD, and Mr. FITZPATRICK) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To direct the Secretary of Health and Human Services to 

issue guidance on coverage under the Medicaid program 

under title XIX of the Social Security Act of certain 

pelvic health services furnished during the postpartum 

period, 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 ‘‘Optimizing 

5 Postpartum Outcomes Act of 2023’’. 


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1 SEC. 2. CMS GUIDANCE. 

2 (a) IN GENERAL.—Not later than 1 year after the 

3 date of the enactment of this Act, the Secretary of Health 

4 and Human Services shall issue guidance on coverage 

5 under State plans (or waivers of such plans) under the 

6 Medicaid program under title XIX of the Social Security 

7 Act (42 U.S.C. 1396 et seq.) or State child health plans 

8 (or waivers of such plans) under the Children’s Health In9 surance Program under title XXI of such Act (42 U.S.C. 

10 1397aa et seq.) of covered pelvic health services furnished 

11 during the prenatal or postpartum period. Such guidance 

12 shall include— 

13 (1) best practices from States with respect to 

14 innovative or evidenced-based payment models to in15 crease access to covered pelvic health services; 

16 (2) recommendations for States on available fi17 nancing options under— 

18 (A) the Medicaid program under title XIX 

19 of such Act (42 U.S.C. 1396 et seq.); and 

20 (B) the Children’s Health Insurance Pro21 gram under title XXI of such Act (42 U.S.C. 

22 1397aa et seq.), specifically funds made avail23 able through a Children’s Health Insurance 

24 Program Health Services Initiative; 

25 (3) guidance and technical assistance to State 

26 agencies responsible for administering State plans 


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1 (or waivers of such plans) under the Medicaid pro2 gram under title XIX of the Social Security Act (42 

3 U.S.C. 1396 et seq.) regarding additional flexibilities 

4 and incentives related to screening and referral for, 

5 and access to, covered pelvic health services; and 

6 (4) guidance regarding suggested terminology 

7 and diagnosis codes, such as the International Clas8 sification of Diseases code set, to identify women 

9 with pelvic floor dysfunction and disorders. 

10 (b) GAO STUDY.—Not later than 1 year after the 

11 date of the enactment of this Act, the Comptroller General 

12 of the United States shall conduct a study on, and submit 

13 to Congress a report that addresses, gaps in coverage 

14 for— 

15 (1) covered pelvic health services under State 

16 plans (or waivers of such plans) under the Medicaid 

17 program under title XIX of the Social Security Act 

18 (42 U.S.C. 1396 et seq.) for postpartum women; 

19 and 

20 (2) other services for postpartum women who 

21 received medical assistance under a State plan (or a 

22 waiver of such plan) under the Medicaid program 

23 under title XIX of the Social Security Act (42 

24 U.S.C. 1396 et seq.) during their pregnancy. 

25 (c) DEFINITIONS.—In this section: 


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1 (1) The term ‘‘postpartum period’’ means the 

2 longer of the period of lactation or the 6-month pe3 riod beginning on the last day of a woman’s preg4 nancy. 

5 (2) The term ‘‘covered pelvic health services’’ 

6 means— 

7 (A) pelvic floor examinations (as defined in 

8 section 317L–2 of the Public Health Service 

9 Act, as added by section 2 of this Act); and 

10 (B) pelvic health physical therapy (as de11 fined in such section 317L–2). 

12 SEC. 3. POSTPARTUM PELVIC HEALTH EDUCATION CAM13 PAIGN. 

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

15 (42 U.S.C. 243 et seq.) is amended by inserting after sec16 tion 317L–1 (42 U.S.C. 247b–13a) the following: 

17 ‘‘SEC. 317L–2. POSTPARTUM PELVIC HEALTH EDUCATION 

18 CAMPAIGN. 

19 ‘‘(a) IN GENERAL.—The Secretary, acting through 

20 the Director of the Centers for Disease Control and Pre21 vention, in collaboration with the Administrator of the 

22 Health Resources and Services Administration and the 

23 heads of other agencies, and in consultation with appro24 priate health professional associations, shall develop and 

25 carry out a program— 


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1 ‘‘(1) to educate and train health professionals 

2 on pelvic floor examinations and the benefits of pel3 vic health physical therapy; and 

4 ‘‘(2) to educate postpartum women on— 

5 ‘‘(A) with respect to pelvic floor examina6 tions— 

7 ‘‘(i) the importance of such examina8 tions during the postpartum period; 

9 ‘‘(ii) how to obtain such an examina10 tion, including information relating to ob11 taining referrals; and 

12 ‘‘(iii) what is involved in such an ex13 amination; and 

14 ‘‘(B) with respect to pelvic health physical 

15 therapy— 

16 ‘‘(i) the benefits of, and availability of 

17 such physical therapy; and 

18 ‘‘(ii) how to obtain a referral for such 

19 physical therapy. 

20 ‘‘(b) DEFINITIONS.—In this section: 

21 ‘‘(1) The term ‘pelvic floor examination’ means 

22 an examination to assess a patient for pelvic health 

23 related conditions that is composed of— 

24 ‘‘(A) an external evaluation that includes 

25 analysis of posture, joint integrity, muscle perVerDate Sep 11 2014 22:43 Apr 13, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2480.IH H2480

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1 formance, quality of movement, and palpation 

2 and observation of the pelvic floor; and 

3 ‘‘(B) if deemed necessary based on the 

4 health care professional’s clinical reasoning, an 

5 internal vaginal or rectal examination, or both, 

6 to gather relevant information about the tone, 

7 strength, control, ability to contract and relax 

8 the muscles of the pelvic floor individually and 

9 together, the condition of the surrounding fas10 cia, and the position of the organs. 

11 ‘‘(2) The term ‘pelvic health physical therapy’ 

12 means a personalized physical therapy plan imple13 mented by a pelvic health physical therapist, after 

14 performing a pelvic floor examination and making a 

15 diagnosis, that is based on best available evidence to 

16 improve the patient condition, with respect to the 

17 anatomy of the pelvic floor, improve mobility, re18 cover from injury, prevent future injury, and man19 age pain and chronic conditions. 

20 ‘‘(3) The term ‘pelvic health related condition’ 

21 includes urinary dysfunction, bowel dysfunction, 

22 musculoskeletal dysfunction, sexual dysfunction, can23 cer-related rehabilitation, and the pre-partum state 

24 and pre-partum conditions. 


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1 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $2,000,000 for each of fiscal years 2024 through 2028.’’. 

Æ 


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