117 
(2) provide access to healthy foods and coun-
seling on nutrition, recommended activity levels, and 
safety measures throughout pregnancy; 
(3) train correctional officers to ensure that 
pregnant incarcerated individuals receive safe and 
respectful treatment; 
(4) train medical personnel to ensure that preg-
nant incarcerated individuals receive trauma-in-
formed, culturally congruent care that promotes the 
health and safety of the pregnant individuals; 
(5) provide counseling and treatment for indi-
viduals who have suffered from— 
(A) diagnosed mental or behavioral health 
conditions, including trauma and substance use 
disorders; 
(B) trauma or violence, including domestic 
violence; 
(C) human immunodeficiency virus; 
(D) sexual abuse; 
(E) pregnancy or infant loss; or 
(F) chronic conditions; 
(6) provide evidence-based pregnancy and child-
birth education, parenting support, and other rel-
evant forms of health literacy; 
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(7) provide clinical education opportunities to 
maternity care providers in training to expand path-
ways into maternal health care careers serving incar-
cerated individuals; 
(8) offer opportunities for postpartum individ-
uals to maintain contact with the individual’s new-
born child to promote bonding, including enhanced 
visitation policies, access to prison nursery pro-
grams, or breastfeeding support; 
(9) provide reentry assistance, particularly to— 
(A) ensure access to health insurance cov-
erage and transfer of health records to commu-
nity providers if an incarcerated individual exits 
the criminal justice system during such individ-
ual’s pregnancy or in the postpartum period; 
and 
(B) connect individuals exiting the criminal 
justice system during pregnancy or in the 
postpartum period to community-based re-
sources, such as referrals to health care pro-
viders, substance use disorder treatments, and 
social services that address social determinants 
of maternal health; or 
(10) establish partnerships with local public en-
tities, private community entities, community-based 
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organizations, Indian Tribes and tribal organizations 
(as such terms are defined in section 4 of the Indian 
Self-Determination and Education Assistance Act 
(25 U.S.C. 5304)), and urban Indian organizations 
(as such term is defined in section 4 of the Indian 
Health Care Improvement Act (25 U.S.C. 1603)) to 
establish or expand pretrial diversion programs as 
an alternative to incarceration for pregnant and 
postpartum individuals. Such programs may in-
clude— 
(A) evidence-based childbirth education or 
parenting classes; 
(B) prenatal health coordination; 
(C) family and individual counseling; 
(D) evidence-based screenings, education, 
and, as needed, treatment for mental and be-
havioral health conditions, including drug and 
alcohol treatments; 
(E) family case management services; 
(F) domestic violence education and pre-
vention; 
(G) physical and sexual abuse counseling; 
and 
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(H) programs to address social deter-
minants of health such as employment, housing, 
education, transportation, and nutrition. 
(d) PRIORITY.—In awarding grants under this sec-
tion, the Director of the Bureau of Justice Assistance 
shall give priority to applicants based on— 
(1) the number of pregnant and postpartum in-
dividuals incarcerated in the State and, among such 
individuals, the number of pregnant and postpartum 
individuals from racial and ethnic minority groups; 
and 
(2) the extent to which the State has dem-
onstrated a commitment to developing exemplary 
programs for pregnant and postpartum individuals 
incarcerated in the prisons and jails in the State. 
(e) GRANT DURATION.—A grant awarded under this 
section shall be for a 5-year period. 
(f) IMPLEMENTING AND REPORTING.—A State that 
receives a grant under this section shall be responsible 
for— 
(1) implementing the program funded by the 
grant; and 
(2) not later than 3 years after the date of en-
actment of this Act, and 6 years after the date of 
enactment of this Act, reporting results of such pro-
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gram to the Attorney General, including information 
describing— 
(A) relevant quantitative indicators of the 
program’s success in improving the standard of 
care and health outcomes for pregnant and 
postpartum incarcerated individuals in the facil-
ity, including data stratified by race, ethnicity, 
sex, gender, age, geography, disability status, 
category of the criminal charge against such in-
dividual, incidence rates of pregnancy-related 
deaths, pregnancy-associated deaths, cases of 
infant mortality and morbidity, rates of preterm 
births and low-birthweight births, cases of se-
vere maternal morbidity, cases of violence 
against pregnant or postpartum individuals, di-
agnoses of maternal mental or behavioral health 
conditions, and other such information as ap-
propriate; 
(B) relevant qualitative and quantitative 
evaluations from pregnant and postpartum in-
carcerated individuals who participated in such 
programs, including measures of patient-re-
ported experience of care; and 
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(C) strategies to sustain such programs be-
yond the duration of the grant and expand such 
programs to other facilities. 
(g) REPORT.—Not later than 6 years after the date 
of enactment of this Act, the Attorney General shall sub-
mit to the Congress a report describing the results of such 
grant programs. 
(h) OVERSIGHT.—Not later than 1 year after the 
date of enactment of this Act, the Attorney General shall 
award a contract to an independent organization or inde-
pendent organizations to conduct oversight of the pro-
grams described in subsection (c). 
(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$10,000,000 for each of fiscal years 2023 through 2027. 
SEC. 1604. GAO REPORT. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Comptroller General 
of the United States shall submit to Congress a report 
on adverse maternal and infant health outcomes among 
incarcerated individuals and infants born to such individ-
uals, with a particular focus on racial and ethnic dispari-
ties in maternal and infant health outcomes for incarcer-
ated individuals. 
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ated individuals in Bureau of Prisons facilities and 
State and local prisons and jails; and 
(6) such other information as may be appro-
priate to reduce the occurrence of adverse maternal 
health outcomes among incarcerated individuals and 
to address racial and ethnic disparities in maternal 
health outcomes for such individuals. 
SEC. 1605. MACPAC REPORT. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Medicaid and CHIP 
Payment and Access Commission (referred to in this sec-
tion as ‘‘MACPAC’’) shall publish a report on the implica-
tions of pregnant and postpartum incarcerated individuals 
being ineligible for medical assistance under a State plan 
under title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) that contains the information described in 
subsection. 
(b) INFORMATION DESCRIBED.—For purposes of 
subsection (a), the information described in this sub-
section includes— 
(1) information on the effect of ineligibility for 
medical assistance under a State plan under title 
XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) on maternal health outcomes for pregnant and 
postpartum incarcerated individuals, concentrating 
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on the effects of such ineligibility for pregnant and 
postpartum individuals from racial and ethnic mi-
nority groups; and 
(2) the potential implications on maternal 
health outcomes resulting from suspending eligibility 
for medical assistance under a State plan under 
such title of such Act when a pregnant or 
postpartum individual is incarcerated. 
Subtitle H—Tech to Save Moms 
SEC. 1701. INTEGRATED TELEHEALTH MODELS IN MATER-
NITY CARE SERVICES. 
(a) IN GENERAL.—Section 1115A(b)(2)(B) of the 
Social Security Act (42 U.S.C. 1315a(b)(2)(B)) is amend-
ed by adding at the end the following: 
‘‘(xxviii) Focusing on title XIX, pro-
viding for the adoption of and use of tele-
health tools that allow for screening, moni-
toring, and management of common health 
complications with respect to an individual 
receiving medical assistance during such 
individual’s pregnancy and for not more 
than a 1-year period beginning on the last 
day of the pregnancy.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall take effect 1 year after the date of 
the enactment of this Act. 
SEC. 1702. GRANTS TO EXPAND THE USE OF TECHNOLOGY- 
ENABLED COLLABORATIVE LEARNING AND 
CAPACITY 
MODELS 
FOR 
PREGNANT 
AND 
POSTPARTUM INDIVIDUALS. 
Title III of the Public Health Service Act is amended 
by inserting after section 330P (42 U.S.C. 254c–22) the 
following: 
‘‘SEC. 
330Q. 
EXPANDING 
CAPACITY 
FOR 
MATERNAL 
HEALTH OUTCOMES. 
‘‘(a) ESTABLISHMENT.—Beginning not later than 1 
year after the date of enactment of this section, the Sec-
retary shall award grants to eligible entities to evaluate, 
develop, and expand the use of technology-enabled collabo-
rative learning and capacity building models and improve 
maternal health outcomes— 
‘‘(1) in health professional shortage areas; 
‘‘(2) in areas with high rates of maternal mor-
tality and severe maternal morbidity; 
‘‘(3) in areas with significant racial and ethnic 
disparities in maternal health outcomes; and 
‘‘(4) for medically underserved populations and 
American Indians and Alaska Natives, including In-
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dian Tribes, Tribal organizations, and Urban Indian 
organizations. 
‘‘(b) USE OF FUNDS.— 
‘‘(1) REQUIRED
USES.—Recipients of grants 
under this section shall use the grants to— 
‘‘(A) train maternal health care providers, 
students, 
and 
other 
similar 
professionals 
through models that include— 
‘‘(i) methods to increase safety and 
health care quality; 
‘‘(ii) implicit bias, racism, and dis-
crimination; 
‘‘(iii) best practices in screening for 
and, as needed, evaluating and treating 
maternal mental health conditions and 
substance use disorders; 
‘‘(iv) training on best practices in ma-
ternity care for pregnant and postpartum 
individuals during the COVID–19 public 
health emergency or future public health 
emergencies; 
‘‘(v) methods to screen for social de-
terminants of maternal health risks in the 
prenatal and postpartum; and 
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‘‘(vi) the use of remote patient moni-
toring tools for pregnancy-related com-
plications 
described 
in 
section 
1115A(b)(2)(B)(xxviii); 
‘‘(B) evaluate and collect information on 
the effect of such models on— 
‘‘(i) access to and quality of care; 
‘‘(ii) outcomes with respect to the 
health of an individual; and 
‘‘(iii) the experience of individuals who 
receive pregnancy-related health care; 
‘‘(C) develop qualitative and quantitative 
measures to identify best practices for the ex-
pansion and use of such models; 
‘‘(D) study the effect of such models on 
patient outcomes and maternity care providers; 
and 
‘‘(E) conduct any other activity determined 
by the Secretary. 
‘‘(2) PERMISSIBLE USES.—Recipients of grants 
under this section may use grants to support— 
‘‘(A) the use and expansion of technology- 
enabled collaborative learning and capacity 
building models, including hardware and soft-
ware that— 
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‘‘(i) enables distance learning and 
technical support; and 
‘‘(ii) supports the secure exchange of 
electronic health information; and 
‘‘(B) maternity care providers, students, 
and other similar professionals in the provision 
of maternity care through such models. 
‘‘(c) APPLICATION.— 
‘‘(1) IN GENERAL.—An eligible entity seeking a 
grant under subsection (a) shall submit to the Sec-
retary an application, at such time, in such manner, 
and containing such information as the Secretary 
may require. 
‘‘(2) ASSURANCE.—An application under para-
graph (1) shall include an assurance that such entity 
shall collect information on and assess the effect of 
the use of technology-enabled collaborative learning 
and capacity building models, including with respect 
to— 
‘‘(A) maternal health outcomes; 
‘‘(B) access to maternal health care serv-
ices; 
‘‘(C) quality of maternal health care; and 
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‘‘(D) retention of maternity care providers 
serving areas and populations described in sub-
section (a). 
‘‘(d) LIMITATIONS.— 
‘‘(1) NUMBER.—The Secretary may not award 
more than 1 grant under this section. 
‘‘(2) DURATION.—A grant awarded under this 
section shall be for a 5-year period. 
‘‘(e) ACCESS
TO BROADBAND.—In administering 
grants under this section, the Secretary may coordinate 
with other agencies to ensure that funding opportunities 
are available to support access to reliable, high-speed 
internet for grantees. 
‘‘(f) TECHNICAL ASSISTANCE.—The Secretary shall 
provide (either directly or by contract) technical assistance 
to eligible entities, including recipients of grants under 
subsection (a), on the development, use, and sustainability 
of technology-enabled collaborative learning and capacity 
building models to expand access to maternal health care 
services provided by such entities, including— 
‘‘(1) in health professional shortage areas; 
‘‘(2) in areas with high rates of maternal mor-
tality and severe maternal morbidity or significant 
racial and ethnic disparities in maternal health out-
comes; and 
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‘‘(3) for medically underserved populations or 
American Indians and Alaska Natives. 
‘‘(g) RESEARCH AND EVALUATION.—The Secretary, 
in consultation with experts, shall develop a strategic plan 
to research and evaluate the evidence for such models. 
‘‘(h) REPORTING.— 
‘‘(1) ELIGIBLE
ENTITIES.—An eligible entity 
that receives a grant under subsection (a) shall sub-
mit to the Secretary a report, at such time, in such 
manner, and containing such information as the Sec-
retary may require. 
‘‘(2) SECRETARY.—Not later than 4 years after 
the date of enactment of this section, the Secretary 
shall submit to the Congress, and make available on 
the website of the Department of Health and 
Human Services, a report that includes— 
‘‘(A) a description of grants awarded 
under subsection (a) and the purpose and 
amounts of such grants; 
‘‘(B) a summary of— 
‘‘(i) the evaluations conducted under 
subsection (b)(B); 
‘‘(ii) any technical assistance provided 
under subsection (g); and 
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‘‘(iii) the activities conducted under 
subsection (a); and 
‘‘(C) a description of any significant find-
ings with respect to— 
‘‘(i) patient outcomes; and 
‘‘(ii) best practices for expanding, 
using, or evaluating technology-enabled col-
laborative learning and capacity building 
models. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$6,000,000 for each of fiscal years 2023 through 2027. 
‘‘(j) DEFINITIONS.—In this section: 
‘‘(1) ELIGIBLE ENTITY.— 
‘‘(A) IN GENERAL.—The term ‘eligible en-
tity’ means an entity that provides, or supports 
the provision of, maternal health care services 
or other evidence-based services for pregnant 
and postpartum individuals— 
‘‘(i) in health professional shortage 
areas; 
‘‘(ii) in areas with high rates of ad-
verse maternal health outcomes or signifi-
cant racial and ethnic disparities in mater-
nal health outcomes; and 
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‘‘(iii) who are— 
‘‘(I) members of medically under-
served populations; or 
‘‘(II) American Indians and Alas-
ka Natives, including Indian Tribes, 
Tribal organizations, and urban In-
dian organizations. 
‘‘(B) INCLUSIONS.—An eligible entity may 
include entities that lead, or are capable of 
leading a technology-enabled collaborative learn-
ing and capacity building model. 
‘‘(2) 
HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—The term ‘health professional shortage area’ 
means a health professional shortage area des-
ignated under section 332. 
‘‘(3) INDIAN TRIBE.—The term ‘Indian Tribe’ 
has the meaning given such term in section 4 of the 
Indian Self-Determination and Education Assistance 
Act. 
‘‘(4) MATERNAL MORTALITY.—The term ‘ma-
ternal mortality’ means a death occurring during or 
within 1-year period after pregnancy caused by preg-
nancy-related or childbirth complications, including a 
suicide, overdose, or other death resulting from a 
mental health or substance use disorder attributed 
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to or aggravated by pregnancy or childbirth com-
plications. 
‘‘(5) 
MEDICALLY
UNDERSERVED
POPU-
LATION.—The term ‘medically underserved popu-
lation’ has the meaning given such term in section 
330(b)(3). 
‘‘(6) POSTPARTUM.—The term ‘postpartum’ 
means the 1-year period beginning on the last date 
of an individual’s pregnancy. 
‘‘(7) SEVERE
MATERNAL
MORBIDITY.—The 
term ‘severe maternal morbidity’ means a health 
condition, including a mental health or substance 
use disorder, attributed to or aggravated by preg-
nancy or childbirth that results in significant short- 
term or long-term consequences to the health of the 
individual who was pregnant. 
‘‘(8) TECHNOLOGY-ENABLED
COLLABORATIVE 
LEARNING AND CAPACITY BUILDING MODEL.—The 
term ‘technology-enabled collaborative learning and 
capacity building model’ means a distance health 
education model that connects health care profes-
sionals, and other specialists, through simultaneous 
interactive videoconferencing for the purpose of fa-
cilitating case-based learning, disseminating best 
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practices, and evaluating outcomes in the context of 
maternal health care. 
‘‘(9) TRIBAL ORGANIZATION.—The term ‘Tribal 
organization’ has the meaning given such term in 
section 4 of the Indian Self-Determination and Edu-
cation Assistance Act. 
‘‘(10) URBAN
INDIAN
ORGANIZATION.—The 
term ‘urban Indian organization’ has the meaning 
given such term in section 4 of the Indian Health 
Care Improvement Act.’’. 
SEC. 1703. GRANTS TO PROMOTE EQUITY IN MATERNAL 
HEALTH 
OUTCOMES 
THROUGH 
DIGITAL 
TOOLS. 
(a) IN GENERAL.—Beginning not later than 1 year 
after the date of the enactment of this Act, the Secretary 
of Health and Human Services shall make grants to eligi-
ble entities to reduce racial and ethnic disparities in ma-
ternal health outcomes by increasing access to digital tools 
related to maternal health care. 
(b) APPLICATIONS.—To be eligible to receive a grant 
under this section, an eligible entity shall submit to the 
Secretary an application at such time, in such manner, 
and containing such information as the Secretary may re-
quire. 
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(c) PRIORITIZATION.—In awarding grants under this 
section, the Secretary shall prioritize an eligible entity— 
(1) in an area with high rates of adverse mater-
nal health outcomes or significant racial and ethnic 
disparities in maternal health outcomes; 
(2) in a health professional shortage area des-
ignated under section 332 of the Public Health Serv-
ice Act (42 U.S.C. 254e); and 
(3) that promotes technology that addresses ra-
cial and ethnic disparities in maternal health out-
comes. 
(d) LIMITATIONS.— 
(1) NUMBER.—The Secretary may award not 
more than 1 grant under this section. 
(2) DURATION.—A grant awarded under this 
section shall be for a 5-year period. 
(e) TECHNICAL ASSISTANCE.—The Secretary shall 
provide technical assistance to an eligible entity on the de-
velopment, use, evaluation, and post-grant sustainability 
of digital tools for purposes of promoting equity in mater-
nal health outcomes. 
(f) REPORTING.— 
(1) ELIGIBLE
ENTITIES.—An eligible entity 
that receives a grant under subsection (a) shall sub-
mit to the Secretary a report, at such time, in such 
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manner, and containing such information as the Sec-
retary may require. 
(2) SECRETARY.—Not later than 4 years after 
the date of the enactment of this Act, the Secretary 
shall submit to Congress a report that includes— 
(A) an evaluation on the effectiveness of 
grants awarded under this section to improve 
health outcomes for pregnant and postpartum 
individuals from racial and ethnic minority 
groups; 
(B) recommendations on new grant pro-
grams that promote the use of technology to 
improve such maternal health outcomes; and 
(C) recommendations with respect to— 
(i) technology-based privacy and secu-
rity safeguards in maternal health care; 
(ii) reimbursement rates for maternal 
telehealth services; 
(iii) the use of digital tools to analyze 
large data sets to identify potential preg-
nancy-related complications; 
(iv) barriers that prevent maternity 
care providers from providing telehealth 
services across States; 
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(v) the use of consumer digital tools 
such as mobile phone applications, patient 
portals, and wearable technologies to im-
prove maternal health outcomes; 
(vi) barriers that prevent access to 
telehealth services, including a lack of ac-
cess to reliable, high-speed internet or elec-
tronic devices; 
(vii) barriers to data sharing between 
the Special Supplemental Nutrition Pro-
gram for Women, Infants, and Children 
program and maternity care providers, and 
recommendations for addressing such bar-
riers; and 
(viii) lessons learned from expanded 
access to telehealth related to maternity 
care during the COVID–19 public health 
emergency. 
(g) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$6,000,000 for each of fiscal years 2023 through 2027. 
SEC. 1704. REPORT ON THE USE OF TECHNOLOGY IN MA-
TERNITY CARE. 
(a) IN GENERAL.—Not later than 60 days after the 
date of enactment of this Act, the Secretary of Health and 
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Human Services shall seek to enter an agreement with the 
National Academies of Sciences, Engineering, and Medi-
cine (referred to in this title as the ‘‘National Academies’’) 
under which the National Academies shall conduct a study 
on the use of technology and patient monitoring devices 
in maternity care. 
(b) CONTENT.—The agreement entered into pursu-
ant to subsection (a) shall provide for the study of the 
following: 
(1) The use of innovative technology (including 
artificial intelligence) in maternal health care, in-
cluding the extent to which such technology has af-
fected racial or ethnic biases in maternal health 
care. 
(2) The use of patient monitoring devices (in-
cluding pulse oximeter devices) in maternal health 
care, including the extent to which such devices have 
affected racial or ethnic biases in maternal health 
care. 
(3) Best practices for reducing and preventing 
racial or ethnic biases in the use of innovative tech-
nology and patient monitoring devices in maternity 
care. 
(4) Best practices in the use of innovative tech-
nology and patient monitoring devices for pregnant 
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and postpartum individuals from racial and ethnic 
minority groups. 
(5) Best practices with respect to privacy and 
security safeguards in such use. 
(c) REPORT.—The agreement under subsection (a) 
shall direct the National Academies to complete the study 
under this section, and transmit to Congress a report on 
the results of the study, not later than 24 months after 
the date of enactment of this Act. 
Subtitle I—Impact to Save Moms 
SEC. 1801. PERINATAL CARE ALTERNATIVE PAYMENT 
MODEL DEMONSTRATION PROJECT. 
(a) IN GENERAL.—For the period of fiscal years 
2023 through 2027, the Secretary of Health and Human 
Services (referred to in this section as the ‘‘Secretary’’), 
acting through the Administrator of the Centers for Medi-
care & Medicaid Services, shall establish and implement, 
in accordance with the requirements of this section, a 
demonstration project, to be known as the Perinatal Care 
Alternative Payment Model Demonstration Project (re-
ferred to in this section as the ‘‘Demonstration Project’’), 
for purposes of allowing States to test payment models 
under their State plans under title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.) and State child health 
plans under title XXI of such Act (42 U.S.C. 1397aa et 
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seq.) with respect to maternity care provided to pregnant 
and postpartum individuals enrolled in such State plans 
and State child health plans. 
(b) COORDINATION.—In establishing the Demonstra-
tion Project, the Secretary shall coordinate with stake-
holders such as— 
(1) State Medicaid programs; 
(2) maternity care providers and organizations 
representing maternity care providers; 
(3) relevant organizations representing patients, 
with a particular focus on patients from racial and 
ethnic minority groups; 
(4) relevant community-based organizations, 
particularly organizations that seek to improve ma-
ternal health outcomes for pregnant and postpartum 
individuals from racial and ethnic minority groups; 
(5) perinatal health workers; 
(6) relevant health insurance issuers; 
(7) hospitals, health systems, midwifery prac-
tices, freestanding birth centers (as such term is de-
fined in paragraph (3)(B) of section 1905(l) of the 
Social Security Act (42 U.S.C. 1396d(l))), Feder-
ally-qualified health centers (as such term is defined 
in paragraph (2)(B) of such section), and rural 
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health clinics (as such term is defined in section 
1861(aa) of such Act (42 U.S.C. 1395x(aa))); 
(8) researchers and policy experts in fields re-
lated to maternity care payment models; and 
(9) any other stakeholders as the Secretary de-
termines appropriate, with a particular focus on 
stakeholders from racial and ethnic minority groups. 
(c) CONSIDERATIONS.—In establishing the Dem-
onstration Project, the Secretary shall consider any alter-
native payment model that— 
(1) is designed to improve maternal health out-
comes for racial and ethnic groups with dispropor-
tionate rates of adverse maternal health outcomes; 
(2) includes methods for stratifying patients by 
pregnancy risk level and, as appropriate, adjusting 
payments under such model to take into account 
pregnancy risk level; 
(3) establishes evidence-based quality metrics 
for such payments; 
(4) includes consideration of non-hospital birth 
settings such as freestanding birth centers (as so de-
fined); 
(5) includes consideration of social deter-
minants of maternal health; or 
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(6) includes diverse maternity care teams that 
include— 
(A) maternity care providers, mental and 
behavioral health care providers acting in ac-
cordance with State law, registered dietitians or 
nutrition professionals (as such term is defined 
in 42 U.S.C. 1395x(vv)(2)), and International 
Board Certified Lactation Consultants— 
(i) from racially, ethnically, and pro-
fessionally diverse backgrounds; 
(ii) with experience practicing in ra-
cially and ethnically diverse communities; 
or 
(iii) who have undergone training on 
implicit bias and racism; and 
(B) perinatal health workers. 
(d) ELIGIBILITY.—To be eligible to participate in the 
Demonstration Project, a State shall submit an applica-
tion to the Secretary at such time, in such manner, and 
containing such information as the Secretary may require. 
(e) EVALUATION.—The Secretary shall conduct an 
evaluation of the Demonstration Project to determine the 
impact of the Demonstration Project on— 
(1) maternal health outcomes, with data strati-
fied by race, ethnicity, socioeconomic indicators, and 
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any other factors as the Secretary determines appro-
priate; 
(2) spending on maternity care by States par-
ticipating in the Demonstration Project; 
(3) to the extent practicable, qualitative and 
quantitative measures of patient experience; and 
(4) any other areas of assessment that the Sec-
retary determines relevant. 
(f) REPORT.—Not later than one year after the com-
pletion or termination date of the Demonstration Project, 
the Secretary shall submit to the Congress, and make pub-
licly available, a report containing— 
(1) the results of any evaluation conducted 
under subsection (e); and 
(2) a recommendation regarding whether the 
Demonstration Project should be continued after fis-
cal year 2027 and expanded on a national basis. 
(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section. 
(h) DEFINITIONS.—In this section: 
(1) 
ALTERNATIVE
PAYMENT
MODEL.—The 
term ‘‘alternative payment model’’ has the meaning 
given such term in section 1833(z)(3)(C) of the So-
cial Security Act (42 U.S.C. 1395l(z)(3)(C)). 
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(2) PERINATAL.—The term ‘‘perinatal’’ means 
the period beginning on the day an individual be-
comes pregnant and ending on the last day of the 
1-year period beginning on the last day of such indi-
vidual’s pregnancy. 
(3) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given such term in section 1707(g)(1) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)(1)). 
SEC. 1802. MACPAC REPORT. 
Not later than two years after the date of the enact-
ment of this Act, the Medicaid and CHIP Payment and 
Access Commission shall publish a report on issues relat-
ing to the continuity of coverage under State plans under 
title XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) and State child health plans under title XXI of such 
Act (42 U.S.C. 1397aa et seq.) for pregnant and 
postpartum individuals. Such report shall, at a minimum, 
include the following: 
(1) An assessment of any existing policies 
under such State plans and such State child health 
plans regarding presumptive eligibility for pregnant 
individuals while their application for enrollment in 
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such a State plan or such a State child health plan 
is being processed. 
(2) An assessment of any existing policies 
under such State plans and such State child health 
plans regarding measures to ensure continuity of 
coverage under such a State plan or such a State 
child health plan for pregnant and postpartum indi-
viduals, including such individuals who need to 
change their health insurance coverage during their 
pregnancy or the postpartum period following their 
pregnancy. 
(3) An assessment of any existing policies 
under such State plans and such State child health 
plans regarding measures to automatically reenroll 
individuals who are eligible to enroll under such a 
State plan or such a State child health plan as a 
parent. 
(4) If determined appropriate by the Commis-
sion, any recommendations for the Department of 
Health and Human Services, or such State plans 
and such State child health plans, to ensure con-
tinuity of coverage under such a State plan or such 
a State child health plan for pregnant and 
postpartum individuals. 
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Subtitle J—Maternal Health 
Pandemic Response 
SEC. 1901. DEFINITIONS. 
In this subtitle: 
(1) COVID–19 PUBLIC HEALTH EMERGENCY.— 
The term ‘‘COVID–19 public health emergency’’ 
means the period— 
(A) beginning on the date that the Sec-
retary of Health and Human Services declared 
a public health emergency under section 319 of 
the Public Health Service Act (42 U.S.C. 
247d), with respect to COVID–19; and 
(B) ending on the later of the end of such 
public health emergency, or January 1, 2023. 
(2) RESPECTFUL MATERNITY CARE.—The term 
‘‘respectful maternity care’’ refers to care organized 
for, and provided to, pregnant and postpartum indi-
viduals in a manner that— 
(A) is culturally congruent; 
(B) maintains their dignity, privacy, and 
confidentiality; 
(C) ensures freedom from harm and mis-
treatment; and 
(D) enables informed choice and contin-
uous support. 
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(3) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
SEC. 1902. FUNDING FOR DATA COLLECTION, SURVEIL-
LANCE, 
AND 
RESEARCH 
ON 
MATERNAL 
HEALTH OUTCOMES DURING THE COVID–19 
PUBLIC HEALTH EMERGENCY. 
To conduct or support data collection, surveillance, 
and research on maternal health as a result of the 
COVID–19 public health emergency, including support to 
assist in the capacity building for State, Tribal, territorial, 
and local public health departments to collect and trans-
mit racial, ethnic, and other demographic data related to 
maternal health, there are authorized to be appro-
priated— 
(1) $100,000,000 for the Surveillance for 
Emerging Threats to Mothers and Babies program 
of the Centers for Disease Control and Prevention, 
to support the Centers for Disease Control and Pre-
vention in its efforts to— 
(A) work with public health, clinical, and 
community-based organizations to provide time-
ly, continually updated guidance to families and 
health care providers on ways to reduce risk to 
pregnant and postpartum individuals and their 
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newborns and tailor interventions to improve 
their long-term health; 
(B) partner with more State, Tribal, terri-
torial, and local public health programs in the 
collection and analysis of clinical data on the 
impact 
of 
COVID–19 
on 
pregnant 
and 
postpartum patients and their newborns, par-
ticularly among patients from racial and ethnic 
minority groups; and 
(C) establish regionally based centers of 
excellence to offer medical, public health, and 
other knowledge to ensure communities, espe-
cially communities with large populations of in-
dividuals from racial and ethnic minority 
groups, can help pregnant and postpartum indi-
viduals and newborns get the care and support 
they need; 
(2) $30,000,000 for the Enhancing Reviews 
and Surveillance to Eliminate Maternal Mortality 
program (commonly known as the ‘‘ERASE MM 
program’’) of the Centers for Disease Control and 
Prevention, to support the Centers for Disease Con-
trol and Prevention in expanding its partnerships 
with States and Indian Tribes and provide technical 
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assistance to existing Maternal Mortality Review 
Committees; 
(3) $45,000,000 for the Pregnancy Risk As-
sessment Monitoring System (commonly known as 
the ‘‘PRAMS’’) of the Centers for Disease Control 
and Prevention, to support the Centers for Disease 
Control and Prevention in its efforts to— 
(A) create a COVID–19 supplement to its 
PRAMS questionnaire; 
(B) add questions around experiences of 
respectful 
maternity 
care 
in 
prenatal, 
intrapartum, and postpartum care; 
(C) 
conduct 
a 
rapid 
assessment 
of 
COVID–19 awareness, impact on care and ex-
periences, and use of preventive measures 
among pregnant, laboring and birthing, and 
postpartum individuals during the COVID–19 
public health emergency; and 
(D) work to transition the survey to an 
electronic platform and expand the survey to a 
larger population, with a special focus on reach-
ing underrepresented communities; and 
(4) $15,000,000 for the National Institute of 
Child Health and Human Development, to conduct 
or support research for interventions to mitigate the 
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effects of the COVID–19 public health emergency on 
pregnant and postpartum individuals, with a par-
ticular focus on individuals from racial and ethnic 
minority groups. 
SEC. 1903. COVID–19 MATERNAL HEALTH DATA COLLEC-
TION AND DISCLOSURE. 
(a) AVAILABILITY OF COLLECTED DATA.—The Sec-
retary, acting through the Director of the Centers for Dis-
ease Control and Prevention and the Administrator of the 
Centers for Medicare & Medicaid Services, shall make pub-
licly available on the website of the Centers for Disease 
Control and Prevention data described in subsection (b). 
(b) DATA DESCRIBED.—The data under subsection 
(a) means data collected through Federal surveillance sys-
tems under the Centers for Disease Control and Preven-
tion with respect to COVID–19 and individuals who are 
pregnant or in a postpartum period. Such data shall in-
clude the following: 
(1) Diagnostic testing, including the number of 
pregnant and postpartum individuals who are tested 
for COVID–19 and the number of positive cases. 
(2) Suspected cases of COVID–19 in pregnant 
and birthing individuals and individuals in a 
postpartum period. 
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(3) Serologic testing, including the number of 
pregnant and postpartum individuals tested and the 
number of such serologic tests that were positive. 
(4) Health care treatment for individuals who 
were infected with the virus, including hospitaliza-
tions, emergency room visits, and intensive care unit 
admissions. 
(5) Health outcomes for pregnant individuals 
and infants confirmed or suspected of being infected 
with the virus, including— 
(A) the number of fatalities and case fa-
talities (expressed as the proportion of individ-
uals who were infected with the virus to individ-
uals who died from the virus); and 
(B) the number of stillbirths, infant mor-
tality, pre-term births, infants born with a low- 
birth weight, and cesarean section births. 
(c) INDIAN HEALTH SERVICE.—In carrying out sub-
section (a), the Secretary shall consult with Indian Tribes 
and confer with urban Indian organizations. 
(d) DISAGGREGATED INFORMATION.—In carrying 
out subsection (a), the Secretary shall disaggregate data 
by race, ethnicity, and location. 
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(e) UPDATE.—During the COVID–19 public health 
emergency, the Secretary shall update the data made 
available under this section— 
(1) at least on a monthly basis; and 
(2) not less than one month after the end of 
such public health emergency. 
(f) PRIVACY.—In carrying out subsection (a), the 
Secretary shall take steps to protect the privacy of individ-
uals pursuant to regulations promulgated under section 
264(c) of the Health Insurance Portability and Account-
ability Act of 1996 (42 U.S.C. 1320d–2 note). 
(g) GUIDANCE.— 
(1) IN GENERAL.—Not later than 30 days after 
the date of enactment of this Act, the Secretary 
shall issue guidance to States and local public health 
departments to ensure that— 
(A) laboratories that test specimens for 
COVID–19 receive all relevant demographic 
data on race, ethnicity, pregnancy status, and 
other demographic data as determined by the 
Secretary; and 
(B) data described in subsection (b) is 
disaggregated by race, ethnicity, and location. 
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(2) CONSULTATION.—In carrying out para-
graph (1), the Secretary shall consult with Indian 
Tribes— 
(A) to ensure that such guidance includes 
Tribally developed best practices; and 
(B) to reduce misclassification of American 
Indians and Alaska Natives. 
SEC. 1904. INCLUSION OF PREGNANT INDIVIDUALS AND 
LACTATING INDIVIDUALS IN VACCINE AND 
THERAPEUTIC DEVELOPMENT FOR COVID–19. 
The Director of the National Institutes of Health 
shall when safe and appropriate, support and advance the 
inclusion of pregnant and lactating individuals in thera-
peutic and vaccine clinical trials with respect to the treat-
ment or prevention of COVID–19, including prioritizing 
recommendations made by the Task Force on Research 
Specific to Pregnant Women and Lactating Women estab-
lished under section 2041 of the 21st Century Cures Act 
(42 U.S.C. 289a–2 note) with respect to including such 
individuals in such clinical trials. 
SEC. 1905. PUBLIC HEALTH COMMUNICATION REGARDING 
MATERNAL CARE DURING COVID–19. 
The Director of the Centers for Disease Control and 
Prevention shall conduct a public health education cam-
paign to increase access by pregnant individuals, their em-
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ployers, and their health care providers to accurate, evi-
dence-based information on COVID–19 and pregnancy 
risks, with a particular focus pregnant individuals in un-
derserved communities. 
SEC. 1906. TASK FORCE ON BIRTHING EXPERIENCE AND 
SAFE MATERNITY CARE DURING A PUBLIC 
HEALTH EMERGENCY. 
(a) ESTABLISHMENT.—The Secretary, in consulta-
tion with the Director of the Centers for Disease Control 
and Prevention and the Administrator of the Health Re-
sources and Services Administration, shall convene a task 
force (in this subsection referred to as the ‘‘Task Force’’) 
to develop recommendations, and make such recommenda-
tions publicly available in multiple languages, on respect-
ful maternity care during the COVID–19 public health 
emergency and other public health emergencies, with a 
particular focus on outcomes for individuals from racial 
and ethnic minority groups and other underserved commu-
nities. 
(b) 
CONTENT.—In 
developing 
recommendations 
under paragraph (1), the Task Force shall address the 
following: 
(1) Measures to facilitate respectful maternity 
care. 
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(2) Strategies to increase access to specialized 
care for individuals with high-risk pregnancies. 
(3) COVID–19 diagnostic testing for pregnant 
individuals and individuals in labor. 
(4) The designation of a companion during 
birthing. 
(5) The ability to communicate using an elec-
tronic mobile device during birthing. 
(6) With respect to an individual who has the 
virus that causes COVID–19— 
(A) separation from a newborn after birth; 
and 
(B) ensuring safety while breastfeeding. 
(7) Licensing, training, and reimbursement for 
midwives from racial and ethnic minority groups and 
underserved communities. 
(8) Financial support for perinatal health work-
ers who provide nonclinical support to pregnant indi-
viduals and postpartum individuals from under-
served communities. 
(9) The identification and treatment of prenatal 
and postpartum mental and behavioral health condi-
tions may have developed during or worsened be-
cause of the COVID–19 public health emergency or 
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future public health emergencies, including anxiety, 
substance use disorder, and depression. 
(10) Strategies to address hospital capacity 
issues in communities with an increase in COVID– 
19 cases, or cases of other infectious diseases. 
(11) Options for maternal care that reduce 
cross-contamination and maintain safety and quality 
of care, including auxiliary maternity units and free-
standing birth centers. 
(12) Methods to identify and address racism, 
bias, and discrimination in treatment and support to 
pregnant and postpartum individuals, including— 
(A) evaluating the training of hospital staff 
on implicit bias and racism and respectful ma-
ternity care; and 
(B) the collection of demographic data. 
(13) Other matters the Task Force determines 
appropriate. 
(c) MEMBERSHIP.— 
(1) CHAIR.—The Secretary shall select the 
chair of the Task Force from among the members 
of the Task Force. 
(2) COMPOSITION.—The Task Force shall be 
composed of— 
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(A) representatives of Federal agencies, in-
cluding the agencies listed in paragraph (3); 
(B) three or more representatives of State, 
local, or territorial public health departments 
from different areas in the United States that 
have a large historically marginalized popu-
lation; 
(C) one or more representatives of Tribal 
public health departments; 
(D) one or more obstetrician-gynecologists 
or other physicians who provide obstetric care, 
with consideration for physicians who are from, 
or work in, communities experiencing a high 
rate of mortality and morbidity from COVID– 
19; 
(E) one or more nurses who provide ob-
stetric care, with consideration for physicians 
who are from, or work in, communities experi-
encing a high rate of mortality and morbidity 
from COVID–19; 
(F) one or more perinatal health workers; 
(G) one or more individuals who were 
pregnant or gave birth during the COVID–19 
public health emergency; 
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(H) one or more individuals who had the 
virus that causes COVID–19 and later gave 
birth; 
(I) one or more individuals who have re-
ceived support from a perinatal health; and 
(J) three or more independent experts who 
are racially and ethnically diverse with knowl-
edge on racial and ethnic disparities in— 
(i) public health; 
(ii) maternal health; or 
(iii) maternal mortality and severe 
maternal morbidity. 
(3) FEDERAL
AGENCIES.—The agencies rep-
resented under paragraph (2)(A) shall include the 
following: 
(A) The Department of Health and 
Human Services. 
(B) The Centers for Disease Control and 
Prevention. 
(C) The Centers for Medicare & Medicaid 
Services. 
(D) The Health Resources and Services 
Administration. 
(E) The Indian Health Service. 
(F) The National Institutes of Health. 
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SEC. 1907. GAO REPORT ON MATERNAL HEALTH AND PUB-
LIC HEALTH EMERGENCY PREPAREDNESS. 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Comptroller General 
of the United States shall submit to Congress a report 
on maternal health and public health emergency prepared-
ness. Such report shall include the information and rec-
ommendations described in subsection (b). 
(b) CONTENT OF REPORT.—The report under sub-
section (b) shall include the following: 
(1) A review of prenatal, labor and delivery, 
and postpartum experiences of individuals during 
such public health emergency, including— 
(A) barriers to accessing pregnancy, birth, 
and postpartum care during a pandemic; 
(B) public and private insurance coverage 
with respect to maternal health care, including 
telehealth services; 
(C) to the extent practicable, maternal and 
infant health outcomes by race and ethnicity 
(including quality of care, mortality, morbidity, 
cesarean section rates, preterm birth, preva-
lence of prenatal and postpartum mental health 
conditions and substance use disorders); 
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(D) with respect to such health outcomes, 
the impact of Federal and State policy changes 
during such public health emergency; 
(E) contributing factors to population- 
based disparities in health outcomes, including 
bias and discrimination toward individuals from 
racial and ethnic minority groups; and 
(F) the effect of increased unemployment, 
paid family leave, changes in health care cov-
erage, and other social determinants of health 
for pregnant and postpartum individuals during 
the public health emergency. 
(2) Recommendations on improving the public 
health emergency response and preparedness efforts 
of the Federal Government with respect to maternal 
health, with a focus on outcomes for pregnant and 
postpartum individuals from racial and ethnic mi-
nority groups, including— 
(A) improving research, surveillance, and 
data collection with respect to maternal health; 
(B) factoring maternal health outcomes 
and disparities into decisions regarding dis-
tribution of resources; 
(C) improving the distribution of public 
health funds, data, and information to Indian 
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Tribes and Tribal organizations with regard to 
maternal health during a public health emer-
gency; and 
(D) improving communications during a 
public health emergency with— 
(i) maternity care providers; 
(ii) maternal mental and behavioral 
health care providers; 
(iii) researchers who specialize in ma-
ternal health, maternal mortality, or severe 
maternal morbidity; 
(iv) individuals who experienced preg-
nancy or childbirth during the COVID–19 
public health emergency; 
(v) representatives from community- 
based organizations that address maternal 
health; and 
(vi) perinatal health workers. 
Subtitle K—Protecting Moms and 
Babies Against Climate Change 
SEC. 1911. DEFINITIONS. 
In this subtitle, the following definitions apply: 
(1) ADVERSE MATERNAL AND INFANT HEALTH 
OUTCOMES.—The term ‘‘adverse maternal and in-
fant health outcomes’’ includes the outcomes of 
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200 
(3) DEPUTY COMMISSIONER.—The term ‘‘Dep-
uty Commissioner’’ means the Deputy Commissioner 
who heads the Office of Paid Family and Medical 
Leave established under section 3002(a). 
(4) ELIGIBLE INDIVIDUAL.—The term ‘‘eligible 
individual’’ means an individual who is entitled to a 
benefit under section 3003 for a particular month, 
upon filing an application for such benefit for such 
month. 
(5) INITIAL WAITING PERIOD.—The term ‘‘ini-
tial waiting period’’ means a period beginning with 
the first caregiving day of an individual occurring 
during the individual’s benefit period and ending 
after the earlier of— 
(A) the fifth caregiving day of the indi-
vidual occurring during the benefit period; or 
(B) the month preceding the first month in 
the benefit period during which occur not less 
than 15 caregiving days of the individual. 
(6) QUALIFIED CAREGIVING.—The term ‘‘quali-
fied caregiving’’ means any activity engaged in by an 
individual, other than regular employment, for a rea-
son for which an eligible employee would be entitled 
to leave under subparagraphs (A) through (E) of 
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paragraph (1) of section 102(a) of the Family and 
Medical Leave Act of 1993 (29 U.S.C. 2612(a)). 
(7) SELF-EMPLOYMENT
INCOME.—The term 
‘‘self-employment income’’ has the same meaning as 
such term in section 211(b) of the Social Security 
Act (42 U.S.C. 411(b)). 
(8) STATE.—The term ‘‘State’’ means any 
State of the United States or the District of Colum-
bia or any territory or possession of the United 
States. 
(9) WAGES.—The term ‘‘wages’’, except as such 
term is used in subsection (h)(2) of section 3003, 
has the same meaning as such term in section 209 
of the Social Security Act (42 U.S.C. 409). 
(10) 60-DAY
LIMITATION
PERIOD.—The term 
‘‘60-day limitation period’’ means a period— 
(A) beginning with the first caregiving day 
of an individual occurring during the individ-
ual’s benefit period and after the expiration of 
the individual’s 5-day waiting period, if applica-
ble; and 
(B) ending with the 60th caregiving day of 
the individual occurring during the benefit pe-
riod and after the expiration of the 5-day wait-
ing period, 
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such payment will not be made if the Commis-
sioner determines that the individual is not en-
titled to payment for such month, not later 
than 20 days after the individual’s monthly 
benefit claim report for such month is received. 
Such monthly report shall be filed with the 
Commissioner not later than 15 days after the 
end of each month. 
(B) REVIEW.—If the Commissioner deter-
mines that payment will not be made to an in-
dividual for a month, or if the Commissioner 
determines that payment shall be made based 
on a number of caregiving days in the month 
inconsistent with the number of caregiving days 
in the monthly benefit claim report of the indi-
vidual for such month, the individual may re-
quest review of such determination at any time 
before the end of the 20-day period that begins 
on the date notice of such determination is re-
ceived, except that such 20-day period may be 
extended for good cause. Not later than 20 days 
after the individual requests review of the deter-
mination, the Commissioner shall provide notice 
to the individual of a final determination of 
payment for such month, and shall make pay-
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