I 
111TH CONGRESS 
2D SESSION 
H. R. 6437 
To amend title XIX of the Social Security Act to improve the quality, 
health outcomes, and value of maternity care under the Medicaid and 
CHIP programs by developing a maternity care quality measurement 
program, identifying payment mechanism improvements, and identifying 
essential evidence-based maternity care services. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 18, 2010 
Mr. ENGEL (for himself and Mrs. MYRICK) introduced the following bill; which 
was referred to the Committee on Energy and Commerce 
A BILL 
To amend title XIX of the Social Security Act to improve 
the quality, health outcomes, and value of maternity 
care under the Medicaid and CHIP programs by devel-
oping a maternity care quality measurement program, 
identifying payment mechanism improvements, and iden-
tifying essential evidence-based maternity care services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Partnering to Improve 
Maternity Care Quality Act of 2010’’. 
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SEC. 2. QUALITY MEASURES FOR MATERNITY CARE UNDER 
MEDICAID AND CHIP. 
Title XIX of the Social Security Act is amended by 
inserting after section 1139B the following new section: 
‘‘SEC. 1139C. MATERNITY CARE QUALITY MEASUREMENT. 
‘‘(a) IN GENERAL.—The Secretary shall develop a 
maternity care quality measurement program for care pro-
vided to childbearing women and newborns for use by— 
‘‘(1) a State in administering a State plan 
under title XIX or a State Child Health Plan under 
title XXI; 
‘‘(2) health insurance issuers (as such term is 
defined in section 2791 of the Public Health Service 
Act (42 U.S.C. 300gg–91)) and managed care enti-
ties that enter into contracts with States for the 
purpose of administering such plans; and 
‘‘(3) providers of items and services (including 
accountable care organizations) with respect to items 
and services provided under such plans. 
‘‘(b) IDENTIFICATION OF AN INITIAL SET OF MATER-
NITY CARE QUALITY MEASURES.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2013, the Secretary shall identify, and publish, from 
maternity care quality measures endorsed under sec-
tion 1890(b)(2), an initial core set of maternity care 
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quality measures for use in data collection and re-
porting by— 
‘‘(A) a State in administering a State plan 
under title XIX or a State Child Health Plan 
under title XXI; 
‘‘(B) health insurance issuers (as such 
term is defined in section 2791 of the Public 
Health Service Act (42 U.S.C. 300gg–91)) and 
managed care entities that enter into contracts 
with States for the purpose of administering 
such plans; and 
‘‘(C) providers of items and services (in-
cluding accountable care organizations) with re-
spect to items and services provided under such 
plans. 
‘‘(2) CONSULTATION AND PUBLIC COMMENT.— 
Not later than January 1, 2012, the Secretary 
shall— 
‘‘(A) solicit public comment on a rec-
ommended initial core set of maternity care 
quality measures; and 
‘‘(B) consult with stakeholders identified in 
subsection (i)(1) regarding such measures. 
‘‘(c) DEVELOPMENT
OF
ADDITIONAL
QUALITY 
MEASURES.— 
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‘‘(1) CONTRACTS WITH QUALIFIED ENTITIES.— 
Not later than the end of the 6-month period begin-
ning on the date the Secretary publishes the initial 
measures under subsection (b)(1), the Secretary, 
acting through the Agency for Healthcare Research 
and Quality, in consultation with the Centers for 
Medicare & Medicaid Services, shall enter into 
grants, contracts, or intergovernmental agreements 
with qualified measure development entities for the 
purpose of developing, testing, and validating mater-
nity care quality measures in areas that are not ade-
quately covered by the measures identified under 
subsection (b)(1). 
‘‘(2) QUALIFIED MEASURE DEVELOPMENT EN-
TITY
DEFINED.—For purposes of this subsection, 
the term ‘qualified measure development entity’ 
means an entity that— 
‘‘(A) has demonstrated expertise and ca-
pacity in the development and testing of quality 
measures; 
‘‘(B) has adopted procedures for quality 
measure development that ensure the inclusion 
of— 
‘‘(i) the views of the individuals and 
entities who are identified in subsection 
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(d)(2)(E) and whose performance will be 
assessed by the measures; and 
‘‘(ii) the views of other individuals 
and entities (including patients, con-
sumers, and health care purchasers) who 
will use the data generated as a result of 
the use of the quality measures; 
‘‘(C) for the purpose of ensuring that the 
quality measures developed under this sub-
section meet the requirements to be considered 
for endorsement under section 1890(b)(2), has 
provided assurances to the Secretary that the 
measure development entity will collaborate 
with— 
‘‘(i) the Secretary; 
‘‘(ii) the consensus-based entity with a 
contract under section 1890(a)(1); and 
‘‘(iii) stakeholders (including those 
stakeholders 
identified 
in 
subsection 
(i)(1)), as practicable; 
‘‘(D) has transparent policies regarding 
governance and conflicts of interest; and 
‘‘(E) submits an application to the Sec-
retary at such time, and in such form and man-
ner, as the Secretary may require. 
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‘‘(iii) the postpartum period. 
‘‘(E) Measures that apply to— 
‘‘(i) clinicians and clinician groups; 
‘‘(ii) facilities; 
‘‘(iii) health plans; and 
‘‘(iv) accountable care organizations. 
‘‘(F) Measurement of— 
‘‘(i) disparities; 
‘‘(ii) care coordination; and 
‘‘(iii) shared decision making. 
‘‘(e) 
MATERNITY
CONSUMER
ASSESSMENT
OF 
HEALTHCARE PROVIDERS AND SYSTEMS SURVEYS.— 
‘‘(1) ADAPTION OF SURVEYS.—Not later than 
January 1, 2014, for the purpose of measuring the 
care 
experiences 
of 
childbearing 
women 
and 
newborns, the Agency for Healthcare Research and 
Quality shall adapt the Consumer Assessment of 
Healthcare Providers and Systems program surveys 
of— 
‘‘(A) providers; 
‘‘(B) facilities; and 
‘‘(C) health plans. 
‘‘(2) SURVEYS
MUST
BE
EFFECTIVE.—The 
Agency for Healthcare Research and Quality shall 
ensure that the surveys adapted under paragraph 
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(1) are effective in measuring aspects of care that 
childbearing women and newborns experience, in-
cluding aspects related to— 
‘‘(A) various care settings; 
‘‘(B) various types of caregivers; 
‘‘(C) considerations relating to pain; 
‘‘(D) the use of medications; 
‘‘(E) shared decision making— 
‘‘(i) during pregnancy; 
‘‘(ii) in the intrapartum period; and 
‘‘(iii) in the postpartum period; and 
‘‘(F) the provision of information, emo-
tional support, and comfort measures during 
the intrapartum period. 
‘‘(3) LANGUAGES.—The surveys adapted under 
paragraph (1) shall be available in English and 
Spanish. 
‘‘(4) 
ENDORSEMENT.—The 
Agency 
for 
Healthcare Research and Quality shall submit any 
Consumer Assessment of Healthcare Providers and 
Systems surveys adapted under this subsection to 
the consensus-based entity with a contract under 
section 1890(a)(1) to be considered for endorsement 
under section 1890(b)(2). 
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‘‘(5) CONSULTATION.—The adaption of (and 
process for applying) the surveys under paragraph 
(1) shall be conducted in consultation with the 
stakeholders identified in subsection (i)(1). 
‘‘(f) MEASUREMENT REPORTING.— 
‘‘(1) VOLUNTARY REPORTING.—The Secretary 
shall encourage voluntary and standardized report-
ing to the Secretary, using the maternity care qual-
ity measures identified under subsection (b) and de-
veloped under subsection (c) and the surveys adapt-
ed under subsection (e), by— 
‘‘(A) clinicians (including physicians, mid-
wives, and clinician groups); 
‘‘(B) facilities (including hospitals and 
freestanding birth centers); 
‘‘(C) accountable care organizations; and 
‘‘(D) health plans, 
on the performance of such clinicians, facilities, ac-
countable care organizations, or plans. 
‘‘(2) STANDARDIZED FORMAT AND PROCESS.— 
Not later than January 1, 2013, the Secretary, in 
consultation with the stakeholders identified under 
subsection (i)(1), shall— 
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‘‘(A)(i) develop, validate, and test formats 
and processes for standardized reporting under 
paragraph (1)— 
‘‘(I) to the clinicians, facilities, ac-
countable care organizations, health plans, 
and State agencies identified in paragraph 
(3); and 
‘‘(II) to the patients, policymakers, 
and payers identified in paragraph (4)(A); 
and 
‘‘(ii) update such formats and processes to 
incorporate any additional quality measures de-
veloped under subsection (c) and any surveys 
developed under subsection (e); and 
‘‘(B) reflect best practices for timely, accu-
rate, effective communications for quality meas-
ures, and update such formats and processes as 
appropriate. 
‘‘(3) FEEDBACK REPORTS.— 
‘‘(A) CLINICIANS, FACILITIES, ACCOUNT-
ABLE
CARE
ORGANIZATIONS, 
AND
HEALTH 
PLANS.—If the Secretary receives a report from 
a clinician, facility, accountable care organiza-
tion, or health plan under paragraph (1), the 
Secretary shall provide, annually, to such clini-
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cian, facility, accountable care organization, or 
health plan a confidential feedback report that 
contains quality measure data collected through 
the report received under paragraph (1), and, if 
feasible, risk-adjusted benchmarks. Such feed-
back reports shall be designed and used for the 
purpose of quality improvement by such clini-
cian, facility, accountable care organization, or 
plan. 
‘‘(B) STATE
AGENCIES.—The Secretary 
shall provide an annual report to the State 
agency administering or supervising the admin-
istration of a State plan under title XIX or a 
State Child Health plan under title XXI on the 
quality of care provided by clinicians, facilities, 
accountable care organizations, and health 
plans in such State. 
‘‘(4) PUBLIC AVAILABILITY OF DATA.— 
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), the data contained in the reports 
under paragraph (1) shall be made available 
to— 
‘‘(i) patients to use in maternity care 
decision making; and 
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‘‘(ii) policymakers and purchasers to 
assess the quality of maternity care serv-
ices provided under titles XIX and XXI. 
‘‘(B) ENDORSED
AND
VALID.—Data re-
ported under this subsection may only be made 
available under this paragraph, or otherwise 
made public, if— 
‘‘(i) such data are received— 
‘‘(I) from a maternity care qual-
ity measure that is identified under 
subsection (b) or developed under sub-
section (c); or 
‘‘(II) through the use of a survey 
adapted under subsection (e); 
‘‘(ii) endorsed without time-limited 
qualification under section 1890(b)(2); and 
‘‘(iii) the clinician, facility, account-
able care organization, or health plan that 
submitted such data has been given an op-
portunity to confirm the quality and accu-
racy of such data. 
‘‘(g) CONVERSION OF CURRENTLY ENDORSED MEAS-
URES AND CREATION OF INITIAL QUALITY DATASET TO 
ENABLE ELECTRONIC HEALTH RECORDS TO MEASURE 
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THE
CARE
OF
CHILDBEARING
WOMEN
AND 
NEWBORNS.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2012, for the purpose of fostering automated pa-
tient-centered longitudinal quality measurement of 
maternity and newborn care using clinical data, the 
consensus-based entity with a contract under section 
1890(b)(2) shall coordinate— 
‘‘(A) the conversion of endorsed measures 
for the care of childbearing women and 
newborns to eMeasures (as such term is defined 
in subsection (c)(3)(B)); and 
‘‘(B) the development of an initial quality 
dataset for use within electronic health records 
of childbearing women and newborns enrolled in 
a program administered by a State through 
State plans under title XIX and State Child 
Health plans under title XXI for purposes of 
such eMeasures. 
‘‘(2) REQUIREMENTS FOR EMEASURE CONVER-
SION AND DATASET CREATION.—The conversion to 
eMeasures and the dataset creation under paragraph 
(1) shall, for each quality measure of the care of 
childbearing women or newborns that the consensus- 
based 
entity 
with 
a 
contract 
under 
section 
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1890(b)(2) endorses, use the entity’s measure au-
thoring tool to— 
‘‘(A) specify standard data elements, qual-
ity data elements, and data flow connectors to 
electronic information; 
‘‘(B) specify quality measure logical state-
ments; 
‘‘(C) test quality measure validity with an 
appropriate electronic health record test data-
base; 
‘‘(D) finalize eMeasures for export to elec-
tronic health record systems; and 
‘‘(E) carry out this work in— 
‘‘(i) collaboration with the developer 
or sponsor of each endorsed measure, who 
is responsible, under an agreement with 
the entity that endorsed such measure, for 
updating such measure; and 
‘‘(ii) consultation with the stake-
holders identified in subsection (i)(1). 
‘‘(h) MEASUREMENT PROGRAM REPORTING.—Not 
later than January 1, 2014, and every 2 years thereafter, 
the Secretary shall submit to the Congress and the Med-
icaid and CHIP Payment and Access Commission a report 
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on the status of the maternity care quality measurement 
program under this section, including— 
‘‘(1) the measured results in maternity care 
quality; 
‘‘(2) trends over time in maternity care quality; 
‘‘(3) the adequacy and use of the set of— 
‘‘(A) the quality measures identified under 
subsection (b); 
‘‘(B) the quality measures developed under 
subsection (c); and 
‘‘(C) the surveys adapted under subsection 
(e); 
‘‘(4) the adequacy and use of the reporting for-
mat under subsection (f)(2); 
‘‘(5) the adequacy of the quality dataset under 
subsection (g); and 
‘‘(6) any recommendations for programmatic 
and legislative changes needed to improve the quality 
of care provided to childbearing women and 
newborns under this title and title XXI, including 
recommendations for quality reporting by the States. 
‘‘(i) STAKEHOLDERS.— 
‘‘(1) IN GENERAL.—The stakeholders identified 
in this subsection are— 
‘‘(A) State Medicaid administrators; 
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‘‘(B) maternal-fetal medicine specialists; 
‘‘(C) obstetrician-gynecologists; 
‘‘(D) family physicians; 
‘‘(E) certified nurse-midwives; 
‘‘(F) certified midwives; 
‘‘(G) nurse practitioners; 
‘‘(H) nurses; 
‘‘(I) neonatologists; 
‘‘(J) pediatricians; 
‘‘(K) consumers and their advocates; 
‘‘(L) health quality measurement experts; 
‘‘(M) health quality measure developers; 
‘‘(N) representatives from the consensus- 
based entity with a contract under section 
1890(a) of the Social Security Act; 
‘‘(O) electronic health record developers 
and vendors; 
‘‘(P) employers and purchasers; 
‘‘(Q) health facility and health system 
leaders; and 
‘‘(R) other individuals who are involved in 
the advancement of evidence-based maternity 
care quality measures. 
‘‘(2) 
PROFESSIONAL
ORGANIZATIONS.—The 
stakeholders identified under paragraph (1) may in-
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clude representatives from professional organizations 
and specialty societies (such as the American College 
of Obstetricians and Gynecologists, the American 
Academy of Family Physicians, the American Col-
lege of Nurse-Midwives, the Society for Maternal 
Fetal Medicine, and the Association of Women’s 
Health, Obstetric, and Neonatal Nurses). 
‘‘(j) APPROPRIATION.—Out of any funds in the 
Treasury not otherwise appropriated, there are appro-
priated for each of fiscal years 2011 through 2015, such 
sums as may be necessary for the purpose of carrying out 
this section. Funds appropriated under this subsection 
shall remain available until expended.’’. 
SEC. 3. DEMONSTRATION PROJECT TO EVALUATE PAY-
MENT REFORM IN MATERNITY CARE. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a demonstration project 
to evaluate the use of alternative payment methods under 
the Medicaid program under title XIX of the Social Secu-
rity Act, for the purpose of— 
(1) improving the quality, value, and outcomes 
of maternity care by reliably delivering effective care 
that contributes to improved outcomes; and 
(2) reducing the costs of maternity care for 
beneficiaries under such program by— 
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(A) delivering effective care; 
(B) avoiding overuse of care that may 
cause harm to the beneficiary or a waste of re-
sources, without providing a benefit to the ben-
eficiary; and 
(C) discouraging the provision of care that 
lacks an evidence base and is contrary to strong 
recommendations supported by high quality evi-
dence in clinical practice guidelines from na-
tionally recognized specialty societies and pro-
fessional organizations. 
(b) PAYMENTS.— 
(1) REQUIREMENTS.—Payments made under 
the demonstration project under subsection (a) for 
the provision of medical services shall be adjusted 
for the health conditions and other characteristics of 
Medicaid beneficiaries, as determined by the Sec-
retary. 
(2) ALLOWABLE
PAYMENT
STRUCTURES.— 
Under the demonstration project under subsection 
(a), the Secretary may evaluate alternative payment 
methods, including the following: 
(A) Payments that are defined to cover 
services for a single episode of care for an indi-
vidual woman and her newborn, including— 
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(i) all care from the prenatal through 
the postpartum period; or 
(ii) all care received during the 
intrapartum period. 
(B) Payments based on a condition-ad-
justed capitated rate for a population of women 
and newborns. 
(C) Payments that cover multiple providers 
(such as hospitals, birth centers, physicians, 
midwives, and nurse practitioners) that would 
otherwise be paid separately. 
(D) Payments in the form of ‘‘virtual bun-
dling’’, in which providers are paid separately, 
but the amount of such payments are adjusted 
so that the total of the individual payments to 
each provider remains under a total payment 
budget for the episode of care. 
(E) Payments to providers (including 
doulas, and other providers of continuous labor 
support) and for services (such as shared deci-
sion making, breast-feeding support programs, 
and doula services) that may not currently be 
eligible for direct reimbursement under title 
XIX of the Social Security Act. 
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(F) Payments that cover multiple services 
that would otherwise be paid for separately, or 
that allow greater flexibility as to the type of 
provider, location of service, or approach to care 
than would otherwise be permitted, to enable 
providers to improve outcomes or value. 
(G) Other payment innovations that are 
likely to result in improved maternity care qual-
ity, outcomes, and value (such as payment of 
bonuses for improved outcomes or payments for 
care coordination). 
(3) EVALUATION AND MONITORING.—The Sec-
retary shall also make payments for the purpose of 
collecting data necessary for the evaluation and 
monitoring of the demonstration project under this 
section. 
(c) SCOPE AND SELECTION OF STATES.—The dem-
onstration project under subsection (a) shall be conducted 
in no more than 8 States, which shall be selected by the 
Secretary based on— 
(1) an application that— 
(A) is submitted by a entity or consortium 
that— 
(i) includes the single State agency 
under section 1902(a)(5); and 
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(ii) may include managed care organi-
zations, integrated health systems, and ac-
countable care organizations providing ma-
ternity care to Medicaid and CHIP bene-
ficiaries; and 
(B) specifies the regions and populations 
in the State that will be served by the entity or 
consortium under the demonstration project; 
(2) criteria designed to ensure that, as a whole, 
the demonstration project is, to the greatest extent 
possible, representative of the demographic and geo-
graphic composition of Medicaid beneficiaries nation-
ally; and 
(3) criteria designed to ensure that multiple 
payment models are tested through the demonstra-
tion project. 
(d) PROTECTIONS FOR BENEFICIARIES.— 
(1) NO
ADDITIONAL
COST
SHARING.—Under 
the demonstration project under subsection (a), a 
Medicaid beneficiary shall not be liable for any cost 
sharing in excess of the amount of cost sharing that 
such beneficiary would otherwise be liable for under 
title XIX of the Social Security Act. 
(2) NO REDUCTION IN QUALITY.—A provider 
who provides services to a Medicaid beneficiary 
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under the demonstration project under subsection 
(a) shall provide services that the provider expects 
will result in a similar or improved health outcome 
for such beneficiary, compared with the services such 
beneficiary would receive under title XIX of the So-
cial Security Act if the beneficiary was not receiving 
services under the demonstration project. 
(3) NO DENIAL OF COVERED SERVICES.—In no 
case may a Medicaid beneficiary be denied maternity 
and nonmaternity items and services under the dem-
onstration project under subsection (a) than such 
beneficiary would otherwise receive under title XIX 
of the Social Security Act. 
(e) PERIOD.—The demonstration project under sub-
section (a) shall begin on January 1, 2012, and shall end 
on December 31, 2016. 
(f) REPORTS.— 
(1) STATE REPORTS.—Each entity or consor-
tium with an application that is approved under sub-
section (c) that participates in the demonstration 
project under subsection (a) shall report to the Sec-
retary, in a time, form, and manner specified by the 
Secretary, the data necessary to— 
(A) monitor the— 
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(i) health outcomes of participating 
beneficiaries; 
(ii) the costs of the project; and 
(iii) the quality of maternity care pro-
vided under the project; and 
(B) evaluate the rationale for the selection 
of the items and services included in any bun-
dled payment made by the entity or consortium 
under the project. 
(2) FINAL REPORT.—Not later than December 
31, 2017, the Secretary shall submit to Congress a 
report containing— 
(A) the results of the demonstration 
project under subsection (a); 
(B) an assessment of the influence of med-
ical liability on the results of such project; and 
(C) recommendations for changes in Med-
icaid payment policies to enhance the quality, 
health outcomes, and value of maternity care 
provided through the Medicaid program. 
SEC. 4. ESSENTIAL SERVICES FOR CHILDBEARING WOMEN 
AND NEWBORNS. 
(a) REPORT ON EVIDENCE-BASED MATERNITY CARE 
SERVICES.—The Secretary of Health and Human Services 
is authorized to, and shall seek to, enter an agreement 
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with the Institute of Medicine of the National Academies 
to develop and, not later than January 1, 2013, publish 
a report that, on the basis of the best available evidence, 
identifies the following: 
(1) ESSENTIAL
SERVICES.—The following es-
sential maternity care services: 
(A) A package of evidence-based maternity 
care services that the Institute of Medicine 
identifies as essential for the majority of child-
bearing women and newborns who are healthy 
and at low risk for complications during preg-
nancy, birth, the postpartum period, and the 
newborn period (the 28-day period beginning on 
the date of birth). 
(B) Any additional and differing maternity 
care services that the Institute of Medicine 
identifies as essential to women and newborns 
who are at higher risk than the individuals de-
scribed under paragraph (1) for complications 
during pregnancy, birth, the postpartum period, 
and the newborn period. 
(C) Any pre- and interconception care 
services that have been demonstrated to con-
tribute to improved maternal and newborn out-
comes. 
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(2) LIMITED VALUE AND UNDERSTUDIED SERV-
ICES.—Maternity care services that are identified by 
the Institute of Medicine as— 
(A) being of limited value (including use of 
a specific service for indications that are not 
supported); or 
(B) requiring comparative effectiveness re-
search to clarify the safety and effectiveness of 
such services. 
(b) STRENGTH OF EVIDENCE.—In identifying the es-
sential services under subsection (a)(1), the Institute of 
Medicine shall— 
(1) give priority to maternal care services that 
are supported for use for specific indications or pop-
ulations by systematic reviews with high- or mod-
erate-quality evidence and strong recommendations, 
as determined by a valid assessment system, such as 
GRADE (Grading of Recommendations Assessment, 
Development and Evaluation); and 
(2) clearly indicate if a service that is rec-
ommended as essential is based on lower quality evi-
dence or weaker recommendations than the levels de-
scribed under paragraph (1). 
(c) CONSULTATIVE PROCESS.— 
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(1) IN GENERAL.—The Institute of Medicine 
shall develop the report under subsection (a) in con-
sultation with a multistakeholder panel that includes 
representatives of— 
(A) clinicians with expertise in— 
(i) obstetrics; 
(ii) family medicine; 
(iii) pediatrics; 
(iv) midwifery; 
(v) nursing; 
(vi) maternal fetal medicine; 
(vii) genetics; 
(viii) anesthesia; 
(ix) substance abuse; 
(x) reproductive endocrinology; 
(xi) mental health; 
(xii) infectious disease; and 
(xiii) interconception care; 
(B) consumers and their advocates; 
(C) payers and purchasers; and 
(D) research methodology experts. 
(2) PROFESSIONAL ORGANIZATIONS.—The rep-
resentatives under paragraph (1) may include rep-
resentatives from professional organizations and spe-
cialty societies (such as the American College of Ob-
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stetricians and Gynecologists, the American Acad-
emy of Family Physicians, the American College of 
Nurse-Midwives, the Society for Maternal Fetal 
Medicine, and the Association of Women’s Health, 
Obstetric, and Neonatal Nurses). 
(d) DEFINITION OF MATERNAL CARE SERVICES.— 
For purposes of the report under subsection (a), the term 
‘‘maternity care services’’ shall include— 
(1) services related to the confirmation of preg-
nancy and preconception, prenatal, intrapartum, 
postpartum, newborn, and interconception care; 
(2) newborn care services that are incidental to 
interconception care; 
(3) mental health and substance abuse services; 
and 
(4) support services (such as language trans-
lation and care coordination). 
(e) SENSE OF CONGRESS.—It is the sense of Con-
gress that the Administrator of the Centers for Medicare 
& Medicaid Services and the directors of State Medicaid 
agencies should ensure that the services available to child-
bearing women and newborns under the Medicaid program 
in each State are well-aligned with the essential maternity 
care services identified in subsection (a)(1). 
Æ 
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