294 
holder, national organization with a national 
data-driven maternal safety and quality im-
provement initiative based on implementation 
approaches that have been proven to improve 
maternal safety and outcomes in the United 
States. 
(3) USE OF FUNDS.—An eligible entity that re-
ceives a grant under paragraph (1) shall use such 
grant funds— 
(A) to develop and implement, through a 
robust, multi-stakeholder process, maternal 
safety bundles to assist States, perinatal quality 
collaboratives, and health care systems in align-
ing national, State, and hospital-level quality 
improvement efforts to improve maternal health 
outcomes, specifically the reduction of maternal 
mortality and severe maternal morbidity; 
(B) to ensure, in developing and imple-
menting maternal safety bundles under sub-
paragraph (A), that such maternal safety bun-
dles— 
(i) satisfy the quality improvement 
needs of a State, perinatal quality collabo-
rative, or health care system by factoring 
in the results and findings of relevant data 
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295 
reviews, such as reviews conducted by a 
State maternal mortality review committee; 
and 
(ii) address topics which may in-
clude— 
(I) information on evidence-based 
practices to improve the quality and 
safety of maternal health care in hos-
pitals and other health care settings 
of a State or health care system, in-
cluding by addressing topics com-
monly associated with health com-
plications or risks related to prenatal 
care, labor care, birthing, and post-
partum care; 
(II) best practices for improving 
maternal health care based on data 
findings and reviews conducted by a 
State maternal mortality review com-
mittee that address topics of relevance 
to common complications or health 
risks related to prenatal care, labor 
care, birthing, and postpartum care; 
(III) information on addressing 
determinants of health that impact 
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296 
maternal health outcomes for women 
before, during, and after pregnancy; 
(IV) obstetric hemorrhage; 
(V) obstetric and postpartum 
care for women with substance use 
disorders, including opioid use dis-
order; 
(VI) maternal cardiovascular sys-
tem; 
(VII) maternal mental health; 
(VIII) postpartum care basics for 
maternal safety; 
(IX) reduction of peripartum ra-
cial and ethnic disparities; 
(X) reduction of primary cae-
sarean birth; 
(XI) severe hypertension in preg-
nancy; 
(XII) severe maternal morbidity 
reviews; 
(XIII) support after a severe ma-
ternal morbidity event; 
(XIV) thromboembolism; 
(XV) optimization of support for 
breastfeeding; 
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297 
(XVI) maternal oral health; and 
(XVII) intimate partner violence; 
and 
(C) to provide ongoing technical assistance 
at the national and State levels to support im-
plementation of maternal safety bundles under 
subparagraph (A). 
(4) MATERNAL
SAFETY
BUNDLE
DEFINED.— 
For purposes of this subsection, the term ‘‘maternal 
safety bundle’’ means standardized, evidence-in-
formed processes for maternal health care. 
(5) AUTHORIZATION OF APPROPRIATIONS.—For 
purposes of carrying out this subsection, there is au-
thorized to be appropriated $10,000,000 for each of 
fiscal years 2023 through 2027. 
(d) FUNDING FOR STATE-BASED PERINATAL QUAL-
ITY
COLLABORATIVES
DEVELOPMENT
AND
SUSTAIN-
ABILITY.— 
(1) IN
GENERAL.—Not later than one year 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services (referred to in 
this subsection as the ‘‘Secretary’’), acting through 
the Division of Reproductive Health of the Centers 
for Disease Control and Prevention, shall establish a 
grant program to be known as the State-Based 
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298 
Perinatal Quality Collaborative grant program under 
which the Secretary awards grants to eligible entities 
for the purpose of development and sustainability of 
perinatal quality collaboratives in every State, the 
District of Columbia, and eligible territories, in 
order to measurably improve perinatal care and 
perinatal 
health 
outcomes 
for 
pregnant 
and 
postpartum women and their infants. 
(2) GRANT AMOUNTS.—Grants awarded under 
this subsection shall be in amounts not to exceed 
$250,000 per year, for the duration of the grant pe-
riod. 
(3) STATE-BASED
PERINATAL
QUALITY
COL-
LABORATIVE DEFINED.—For purposes of this sub-
section, the term ‘‘State-based perinatal quality col-
laborative’’ means a network of teams that— 
(A) is multidisciplinary in nature and in-
cludes the full range of perinatal and maternity 
care providers; 
(B) works to improve measurable outcomes 
for maternal and infant health by advancing 
evidence-informed clinical practices using qual-
ity improvement principles; 
(C) works with hospital-based or out-
patient facility-based clinical teams, experts, 
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299 
and stakeholders, including patients and fami-
lies, to spread best practices and optimize re-
sources to improve perinatal care and outcomes; 
(D) employs strategies that include the use 
of the collaborative learning model to provide 
opportunities for hospitals and clinical teams to 
collaborate on improvement strategies, rapid-re-
sponse data to provide timely feedback to hos-
pital and other clinical teams to track progress, 
and quality improvement science to provide sup-
port and coaching to hospital and clinical 
teams; 
(E) has the goal of improving population- 
level outcomes in maternal and infant health; 
and 
(F) has the goal of improving outcomes of 
all birthing people, through the coordination, 
integration, and collaboration across birth set-
tings. 
(4) AUTHORIZATION OF APPROPRIATIONS.—For 
purposes of carrying out this subsection, there is au-
thorized to be appropriated $14,000,000 per year 
for each of fiscal years 2023 through 2027. 
(e) EXPANSION OF MEDICAID AND CHIP COVERAGE 
FOR PREGNANT AND POSTPARTUM WOMEN.— 
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300 
(1) REQUIRING COVERAGE OF ORAL HEALTH 
SERVICES
FOR
PREGNANT
AND
POSTPARTUM 
WOMEN.— 
(A) MEDICAID.—Section 1905 of the So-
cial Security Act (42 U.S.C. 1396d) is amend-
ed— 
(i) in subsection (a)(4)— 
(I) by striking ‘‘; and (F)’’ and 
inserting ‘‘; (F)’’; and 
(II) by inserting ‘‘; and (G) oral 
health services for pregnant and 
postpartum women (as defined in sub-
section (jj))’’ after ‘‘if otherwise cov-
ered under the State plan (or waiver 
of such plan)’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(jj) ORAL HEALTH SERVICES FOR PREGNANT AND 
POSTPARTUM WOMEN.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘oral health services for pregnant and 
postpartum women’ means dental services necessary 
to prevent disease and promote oral health, restore 
oral structures to health and function, and treat 
emergency conditions that are furnished to a woman 
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301 
during pregnancy (or during the 1-year period be-
ginning on the last day of the pregnancy). 
‘‘(2) COVERAGE
REQUIREMENTS.—To satisfy 
the requirement to provide oral health services for 
pregnant and postpartum women, a State shall, at 
a minimum, provide coverage for preventive, diag-
nostic, periodontal, and restorative care consistent 
with recommendations for perinatal oral health care 
and dental care during pregnancy from the Amer-
ican Academy of Pediatric Dentistry and the Amer-
ican College of Obstetricians and Gynecologists.’’. 
(B) CHIP.—Section 2103(c)(6)(A) of the 
Social 
Security 
Act 
(42 
U.S.C. 
1397cc(c)(6)(A)) is amended by inserting ‘‘or a 
targeted low-income pregnant woman’’ after 
‘‘targeted low-income child’’. 
(2) EXTENDING
MEDICAID
COVERAGE
FOR 
PREGNANT
AND
POSTPARTUM
WOMEN.—Section 
1902 of the Social Security Act (42 U.S.C. 1396a) 
is amended— 
(A) in subsection (e)— 
(i) in paragraph (5)— 
(I) by inserting ‘‘(including oral 
health services for pregnant and 
postpartum women (as defined in sec-
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302 
tion 1905(hh)))’’ after ‘‘postpartum 
medical assistance under the plan’’; 
and 
(II) by striking ‘‘60-day’’ and in-
serting ‘‘1-year’’; and 
(ii) in paragraph (6), by striking ‘‘60- 
day’’ and inserting ‘‘1-year’’; and 
(B) in subsection (l)(1)(A), by striking 
‘‘60-day’’ and inserting ‘‘1-year’’. 
(3) EXTENDING
MEDICAID
COVERAGE
FOR 
LAWFUL
RESIDENTS.—Section 1903(v)(4)(A)(i) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1396b(v)(4)(A)(i)) is amended by striking ‘‘60-day’’ 
and inserting ‘‘1-year’’. 
(4) EXTENDING
CHIP
COVERAGE
FOR
PREG-
NANT
AND
POSTPARTUM
WOMEN.—Section 
2112(d)(2)(A) of the Social Security Act (42 U.S.C. 
1397ll(d)(2)(A)) is amended to read as follows: 
‘‘(A) during pregnancy and through the 
end of the month in which the 1-year period 
(including in the case that subparagraph (A) of 
section 1902(e)(16) applies to the State child 
health plan (or waiver of such plan), pursuant 
to section 2107(e)(1)), beginning on the last 
day of her pregnancy ends;’’. 
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303 
(5) MAINTENANCE OF EFFORT.— 
(A) MEDICAID.—Section 1902(l) of the So-
cial Security Act (42 U.S.C. 1396a(l)) is 
amended by adding at the end the following 
new paragraph: 
‘‘(5) During the period that begins on the date of 
enactment of this paragraph and ends on the date that 
is five years after such date of enactment, as a condition 
for receiving any Federal payments under section 1903(a) 
for calendar quarters occurring during such period, a 
State shall not have in effect, with respect to women who 
are eligible for medical assistance under the State plan 
or under a waiver of such plan on the basis of being preg-
nant or having been pregnant, eligibility standards, meth-
odologies, or procedures under the State plan or waiver 
that are more restrictive than the eligibility standards, 
methodologies, or procedures, respectively, under such 
plan or waiver that are in effect on the date of enactment 
of this paragraph.’’. 
(B) CHIP.—Section 2105(d) of the Social 
Security Act (42 U.S.C. 1397ee(d)) is amended 
by adding at the end the following new para-
graph: 
‘‘(4) IN
ELIGIBILITY
STANDARDS
FOR
TAR-
GETED
LOW-INCOME
PREGNANT
WOMEN.—During 
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304 
the period that begins on the date of enactment of 
this paragraph and ends on the date that is five 
years after such date of enactment, as a condition 
of receiving payments under subsection (a) and sec-
tion 1903(a), a State that elects to provide assist-
ance to women on the basis of being pregnant (in-
cluding pregnancy-related assistance provided to tar-
geted low-income pregnant women (as defined in 
section 2112(d)), pregnancy-related assistance pro-
vided to women who are eligible for such assistance 
through application of section 1902(v)(4)(A)(i) 
under section 2107(e)(1), or any other assistance 
under the State child health plan (or a waiver of 
such plan) which is provided to women on the basis 
of being pregnant) shall not have in effect, with re-
spect to such women, eligibility standards, meth-
odologies, or procedures under such plan (or waiver) 
that are more restrictive than the eligibility stand-
ards, methodologies, or procedures, respectively, 
under such plan (or waiver) that are in effect on the 
date of enactment of this paragraph.’’. 
(6) INFORMATION
ON
BENEFITS.—The Sec-
retary of Health and Human Services shall make 
publicly available on the internet website of the De-
partment of Health and Human Services, informa-
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tion regarding benefits available to pregnant and 
postpartum women and under the Medicaid program 
and the Children’s Health Insurance Program, in-
cluding information on— 
(A) benefits that States are required to 
provide to pregnant and postpartum women 
under such programs; 
(B) optional benefits that States may pro-
vide to pregnant and postpartum women under 
such programs; and 
(C) the availability of different kinds of 
benefits for pregnant and postpartum women, 
including oral health and mental health bene-
fits, under such programs. 
(7) FEDERAL
FUNDING
FOR
COST
OF
EX-
TENDED
MEDICAID
AND
CHIP
COVERAGE
FOR 
POSTPARTUM WOMEN.— 
(A) MEDICAID.—Section 1905 of the So-
cial Security Act (42 U.S.C. 1396d), as amend-
ed by paragraph (1), is further amended— 
(i) in subsection (b), by striking ‘‘and 
(ii)’’ and inserting ‘‘(ii), and (kk)’’; and 
(ii) by adding at the end the fol-
lowing: 
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‘‘(kk) INCREASED FMAP FOR EXTENDED MEDICAL 
ASSISTANCE
FOR
POSTPARTUM
WOMEN.—Notwith-
standing subsection (b), the Federal medical assistance 
percentage for a State, with respect to amounts expended 
by such State for medical assistance for a woman who is 
eligible for such assistance on the basis of being pregnant 
or having been pregnant that is provided during the 305- 
day period that begins on the 60th day after the last day 
of her pregnancy (including any such assistance provided 
during the month in which such period ends), shall be 
equal to— 
‘‘(1) 100 percent for the first 20 calendar quar-
ters during which this subsection is in effect; and 
‘‘(2) 90 percent for calendar quarters there-
after.’’. 
(B) CHIP.—Section 2105(c) of the Social 
Security Act (42 U.S.C. 1397ee(c)) is amended 
by adding at the end the following new para-
graph: 
‘‘(13) ENHANCED
PAYMENT
FOR
EXTENDED 
ASSISTANCE
PROVIDED
TO
PREGNANT
WOMEN.— 
Notwithstanding 
subsection 
(b), 
the 
enhanced 
FMAP, with respect to payments under subsection 
(a) for expenditures under the State child health 
plan (or a waiver of such plan) for assistance pro-
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307 
vided under the plan (or waiver) to a woman who is 
eligible for such assistance on the basis of being 
pregnant (including pregnancy-related assistance 
provided to a targeted low-income pregnant woman 
(as defined in section 2112(d)), pregnancy-related 
assistance provided to a woman who is eligible for 
such assistance through application of section 
1902(v)(4)(A)(i) under section 2107(e)(1), or any 
other assistance under the plan (or waiver) provided 
to a woman who is eligible for such assistance on the 
basis of being pregnant) during the 305-day period 
that begins on the 60th day after the last day of her 
pregnancy (including any such assistance provided 
during the month in which such period ends), shall 
be equal to— 
‘‘(A) 100 percent for the first 20 calendar 
quarters during which this paragraph is in ef-
fect; and 
‘‘(B) 90 percent for calendar quarters 
thereafter.’’. 
(8) GUIDANCE ON STATE OPTIONS FOR MED-
ICAID COVERAGE OF DOULA SERVICES.—Not later 
than 1 year after the date of the enactment of this 
Act, the Secretary of Health and Human Services, 
acting through the Administrator of the Centers for 
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Medicare & Medicaid Services, shall issue guidance 
for the States concerning options for Medicaid cov-
erage and payment for support services provided by 
doulas. 
(9) EFFECTIVE DATE.— 
(A) IN
GENERAL.—Subject to subpara-
graph (B), the amendments made by this sub-
section shall take effect on the first day of the 
first calendar quarter that begins on or after 
the date that is one year after the date of en-
actment of this Act. 
(B) EXCEPTION
FOR
STATE
LEGISLA-
TION.—In the case of a State plan under title 
XIX of the Social Security Act or a State child 
health plan under title XXI of such Act that 
the Secretary of Health and Human Services 
determines requires State legislation in order 
for the respective plan to meet any requirement 
imposed by amendments made by this sub-
section, the respective plan shall not be re-
garded as failing to comply with the require-
ments of such title solely on the basis of its fail-
ure to meet such an additional requirement be-
fore the first day of the first calendar quarter 
beginning after the close of the first regular 
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309 
session of the State legislature that begins after 
the date of enactment of this Act. For purposes 
of the previous sentence, in the case of a State 
that has a 2-year legislative session, each year 
of the session shall be considered to be a sepa-
rate regular session of the State legislature. 
(f) REGIONAL CENTERS OF EXCELLENCE.—Part P 
of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 399V–7. REGIONAL CENTERS OF EXCELLENCE AD-
DRESSING IMPLICIT BIAS AND CULTURAL 
COMPETENCY IN PATIENT-PROVIDER INTER-
ACTIONS EDUCATION. 
‘‘(a) IN GENERAL.—Not later than one year after the 
date of enactment of this section, the Secretary, in con-
sultation with such other agency heads as the Secretary 
determines appropriate, shall award cooperative agree-
ments for the establishment or support of regional centers 
of excellence addressing implicit bias, cultural competency, 
and respectful care practices in patient-provider inter-
actions education for the purpose of enhancing and im-
proving how health care professionals are educated in im-
plicit bias and delivering culturally competent health care. 
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‘‘(b) ELIGIBILITY.—To be eligible to receive a cooper-
ative agreement under subsection (a), an entity shall— 
‘‘(1) be a public or other nonprofit entity speci-
fied by the Secretary that provides educational and 
training opportunities for students and health care 
professionals, which may be a health system, teach-
ing hospital, community health center, medical 
school, school of public health, school of nursing, 
dental school, social work school, school of profes-
sional psychology, or any other health professional 
school or program at an institution of higher edu-
cation (as defined in section 101 of the Higher Edu-
cation Act of 1965) focused on the prevention, treat-
ment, or recovery of health conditions that con-
tribute to maternal mortality and the prevention of 
maternal mortality and severe maternal morbidity; 
‘‘(2) demonstrate community engagement and 
participation, such as through partnerships with 
home visiting and case management programs; 
‘‘(3) demonstrate engagement with groups en-
gaged in the implementation of health care profes-
sional training in implicit bias and delivering cul-
turally competent care, such as departments of pub-
lic health, perinatal quality collaboratives, hospital 
systems, and health care professional groups, in 
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