I 

117TH CONGRESS 

1ST SESSION H. R. 3688 

To address maternal mortality and morbidity. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 4, 2021 

Ms. ADAMS introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To address maternal mortality and morbidity. 

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 ‘‘Modernizing Obstetric 

5 Medicine Standards Act of 2021’’ or the ‘‘MOMS Act of 

6 2021’’. 

7 SEC. 2. MATERNAL MORTALITY AND MORBIDITY PREVEN8 TION. 

9 (a) PREGNANCY AND POSTPARTUM SAFETY AND

10 MONITORING PRACTICES AND MATERNAL MORTALITY

11 AND MORBIDITY PREVENTION.—Section 317K of the 


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1 Public Health Service Act (42 U.S.C. 247b–12) is amend2 ed— 

3 (1) by redesignating subsections (d) through (f) 

4 as subsections (f) through (h), respectively; 

5 (2) in subsection (a)(2)(D), by striking ‘‘sub6 section (d)’’ and inserting ‘‘subsection (f)’’; and 

7 (3) by inserting after subsection (c) the fol8 lowing: 

9 ‘‘(d) PREGNANCY AND POSTPARTUM SAFETY AND

10 MONITORING PRACTICES AND MATERNAL MORTALITY

11 AND MORBIDITY PREVENTION.— 

12 ‘‘(1) ALLIANCE FOR INNOVATION ON MATERNAL

13 HEALTH.—The Secretary, acting through the Asso14 ciate Administrator of the Maternal and Child 

15 Health Bureau of the Health Resources and Services 

16 Administration, shall establish a program, known as 

17 the Alliance for Innovation on Maternal Health pro18 gram, to— 

19 ‘‘(A) enter into a contract with an inter20 disciplinary, multi-stakeholder, national organi21 zation promulgating a national data-driven ma22 ternal safety and quality improvement initiative 

23 based on evidence-based best practices to im24 prove maternal safety and outcomes; 


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1 ‘‘(B) assist States with the development 

2 and implementation of postpartum safety and 

3 monitoring practices and maternal mortality 

4 and morbidity prevention, based on the best 

5 practices developed under paragraph (2); and 

6 ‘‘(C) improve State-specific maternal 

7 health outcomes and reduce variation in re8 sponse to maternity and postpartum care, in 

9 order to eliminate preventable maternal mor10 tality and severe maternal morbidity. 

11 ‘‘(2) BEST PRACTICES.— 

12 ‘‘(A) IN GENERAL.—Not later than 1 year 

13 after the date of enactment of the Modernizing 

14 Obstetric Medicine Standards Act of 2021, the 

15 Secretary, acting through the Administrator of 

16 the Health Resources and Services Administra17 tion, shall work with the contracting entity 

18 under paragraph (1)(A) to— 

19 ‘‘(i) create and assist State-based col20 laborative teams in the implementation of 

21 standardized best practices, to be known as 

22 ‘maternal safety bundles’, for the purpose 

23 of maternal mortality and morbidity pre24 vention; and 


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1 ‘‘(ii) collect and analyze data related 

2 to process structure and patient outcomes 

3 to drive continuous quality improvement in 

4 the implementation of the maternal safety 

5 bundles by such State-based teams. 

6 ‘‘(B) MATERNAL SAFETY BUNDLES.—The 

7 best practices issued under subparagraph (A) 

8 may address the following topics: 

9 ‘‘(i) Obstetric hemorrhage. 

10 ‘‘(ii) Maternal mental, behavioral, and 

11 emotional health. 

12 ‘‘(iii) Maternal venous and thrombo13 embolism. 

14 ‘‘(iv) Severe hypertension in preg15 nancy, including preeclampsia. 

16 ‘‘(v) Obstetric care for women with 

17 substance abuse disorder. 

18 ‘‘(vi) Postpartum care basics for ma19 ternal safety. 

20 ‘‘(vii) Reduction of racial and ethnic 

21 disparities in maternity care. 

22 ‘‘(viii) Safe reduction of primary ce23 sarean birth. 

24 ‘‘(ix) Severe maternal morbidity re25 view. 


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1 ‘‘(x) Support after a severe maternal 

2 morbidity event. 

3 ‘‘(xi) Ways to empower and listen to 

4 women before, during, and after childbirth 

5 to ensure better communication between 

6 patients and health care providers. 

7 ‘‘(xii) Other leading causes of mater8 nal mortality and morbidity, including in9 fection or sepsis and cardiomyopathy. 

10 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

11 To carry out this subsection, in addition to amounts 

12 appropriated under subsection (g), there are author13 ized to be appropriated $5,000,000 for each of fiscal 

14 years 2022 through 2026.’’. 

15 (b) MATERNAL MORTALITY AND MORBIDITY PRE16 VENTION GRANTS.—Section 317K of the Public Health 

17 Service Act (42 U.S.C. 247b–12), as amended by sub18 section (a), is further amended by inserting after sub19 section (d) the following: 

20 ‘‘(e) MATERNAL MORTALITY AND MORBIDITY PRE21 VENTION GRANT PROGRAM.— 

22 ‘‘(1) IN GENERAL.—The Secretary, acting 

23 through the Associate Administrator of the Maternal 

24 and Child Health Bureau of the Health Resources 

25 and Services Administration, shall award grants to 


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1 States or hospitals to assist in the development and 

2 implementation of the maternal safety bundles de3 scribed in subsection (d)(2). 

4 ‘‘(2) USE OF FUNDS.— 

5 ‘‘(A) IN GENERAL.—A State or hospital re6 ceiving a grant under this subsection may use 

7 such funds— 

8 ‘‘(i) to purchase equipment and sup9 plies to effectively implement and execute 

10 the maternal safety bundles described in 

11 subsection (d)(2); and 

12 ‘‘(ii) to develop training on, and eval13 uation of the effectiveness of, such mater14 nal safety bundles. 

15 ‘‘(B) PRIORITY USE OF FUNDS FOR STATE

16 GRANTEES.—A State receiving a grant under 

17 this subsection shall allocate such funds giving 

18 priority to the hospitals in such State that serve 

19 high volumes of low-income, at-risk, or rural 

20 populations. 

21 ‘‘(3) PRIORITIZATION OF GRANT APPLICA22 TIONS.—In awarding grants under this subsection, 

23 the Secretary shall prioritize applications from 

24 States, or hospitals within States, that— 


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1 ‘‘(A) have a functioning maternal mortality 

2 review committee in accordance with best prac3 tices promulgated by the Building U.S. Capac4 ity to Review and Prevent Maternal Deaths Ini5 tiative of the Centers for Disease Control and 

6 Prevention, the CDC Foundation, and the Asso7 ciation of Maternal and Child Health Programs; 

8 or 

9 ‘‘(B) serve high volumes of low-income, at10 risk, or rural populations. 

11 ‘‘(4) REPORTING REQUIREMENTS.— 

12 ‘‘(A) IN GENERAL.—Not later than 2 years 

13 after receipt of a grant under this subsection, 

14 each recipient of such a grant shall submit a re15 port to the Secretary describing— 

16 ‘‘(i) implementation of the maternal 

17 safety bundles with use of the grant funds; 

18 ‘‘(ii) any incidents of pregnancy-re19 lated deaths or pregnancy-associated 

20 deaths, and any pregnancy-related com21 plications or pregnancy-associated com22 plications occurring in the 1-year period 

23 prior to implementation of such proce24 dures; and 


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1 ‘‘(iii) any incidents of pregnancy-re2 lated deaths or pregnancy-associated 

3 deaths, and any pregnancy-related com4 plications or pregnancy-associated com5 plications occurring after implementation 

6 of such procedures. 

7 ‘‘(B) PUBLIC AVAILABILITY; REPORT TO

8 CONGRESS.—Within 1 year of receiving the re9 ports under subparagraph (A), the Secretary 

10 shall— 

11 ‘‘(i) make the reports submitted under 

12 subparagraph (A) publicly available; and 

13 ‘‘(ii) submit a report to Congress that 

14 describes the grants awarded under this 

15 subsection, the effectiveness of the grant 

16 program under this subsection, the activi17 ties for which grant funds were used, and 

18 any recommendations to further prevent 

19 maternal mortality and morbidity. 

20 ‘‘(C) AUTHORIZATION OF APPROPRIA21 TIONS.—To carry out this subsection, in addi22 tion to amounts appropriated under subsection 

23 (g), there are authorized to be appropriated 

24 $40,000,000 for each of fiscal years 2022 

25 through 2026.’’. 


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1 (c) DEFINITIONS.—Subsection (g) of section 317K of 

2 the Public Health Service Act (42 U.S.C. 247b–12), as 

3 redesignated by subsection (a)(1), is amended to read as 

4 follows: 

5 ‘‘(g) DEFINITIONS.—In this section: 

6 ‘‘(1) The terms ‘Indian tribe’ and ‘tribal organi7 zation’ have the meanings given such terms in sec8 tion 4 of the Indian Self-Determination and Edu9 cation Assistance Act. 

10 ‘‘(2) The terms ‘pregnancy-associated death’ 

11 and ‘pregnancy-associated complication’ mean the 

12 death or medical complication, respectively, of a 

13 woman that occurs during, or within 1 year fol14 lowing, her pregnancy, regardless of the outcome, 

15 duration, or site of the pregnancy. 

16 ‘‘(3) The terms ‘pregnancy-related death’ and 

17 ‘pregnancy-related complication’ mean the death or 

18 medical complication, respectively, of a woman 

19 that— 

20 ‘‘(A) occurs during, or within 1 year fol21 lowing, her pregnancy, regardless of the out22 come, duration, or site of the pregnancy; 

23 ‘‘(B) is from any cause related to, or ag24 gravated by, the pregnancy or its management; 

25 and 


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1 ‘‘(C) is not from an accidental or inci2 dental cause. 

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

4 means the unexpected outcomes of labor and deliv5 ery that result in significant short- or long-term con6 sequences to a woman’s health.’’. 

7 SEC. 3. REPORTING ON PREGNANCY-RELATED AND PREG8 NANCY-ASSOCIATED DEATHS AND COMPLICA9 TIONS. 

10 (a) IN GENERAL.—The Secretary of Health and 

11 Human Services shall encourage each State to voluntarily 

12 submit to the Secretary each year a report containing the 

13 findings of a State maternal mortality review committee 

14 with respect to each maternal death in the State that the 

15 committee reviewed during the year. 

16 (b) MATERNAL AND INFANT HEALTH.—The Director 

17 of the Centers for Disease Control and Prevention shall— 

18 (1) update the Pregnancy Mortality Surveil19 lance System or develop a separate system so that 

20 such system is capable of including data obtained 

21 from State maternal mortality review committees; 

22 and 

23 (2) provide technical assistance to States in re24 viewing cases of pregnancy-related complications and 

25 pregnancy-associated complications. 


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1 (c) DEFINITIONS.—In this section, the terms ‘‘preg2 nancy-associated complication’’ and ‘‘pregnancy-related 

3 complication’’ have the meanings given such terms in sec4 tion 317K of the Public Health Service Act, as amended 

5 by section 2. 

Æ 


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