H. R. 2471—744 
(9) The number of full-time equivalent employees funded 
pursuant to fees collected under section 919 of the Federal 
Food, Drug, and Cosmetic Act (21 U.S.C. 387s), including identi-
fication of the centers and offices within the Food and Drug 
Administration in which such positions are located. 
(10) The number of inspections and investigations con-
ducted at domestic and foreign establishments required to reg-
ister under section 905 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 387e). 
(11) The total number of compliance and enforcement 
actions issued or taken with respect to tobacco products, 
including warning letters, civil money penalties, no-tobacco- 
sale orders, and other enforcement actions (including seizures, 
injunctions, and criminal prosecution). 
(c) PUBLIC AVAILABILITY.—The Secretary of Health and Human 
Services shall make the reports required under this section available 
to the public on the website of the Food and Drug Administration. 
(d) LIMITATIONS.—Reporting under this section shall include 
best estimates for any reporting category for which the Food and 
Drug Administration does not have precise calculations. Such best 
estimates shall be accompanied with an explanatory statement 
for why the Food and Drug Administration does not have access 
to, or cannot calculate, the exact figure and a date by which the 
Food and Drug Administration will update its internal accounting 
procedures to allow for such reporting. If a category is successfully 
reported by the Food and Drug Administration with regard to 
another type of user fee but is provided a best estimate by the 
Center for Tobacco Products, the explanatory statement shall 
include information regarding how the Food and Drug Administra-
tion will align systems and apply learning across the agency to 
allow for accurate reporting. 
Subtitle C—Drug Discount Program 
SEC. 121. ELIGIBILITY EXCEPTION FOR THE DRUG DISCOUNT PRO-
GRAM DUE TO THE COVID–19 PUBLIC HEALTH EMER-
GENCY. 
(a) IN GENERAL.—Notwithstanding any other provision of law, 
in the case of a hospital described in subsection (b) that, with 
respect to cost reporting periods that begin during fiscal year 2020 
or a subsequent fiscal year, but do not end after December 31, 
2022, does not meet the applicable requirement for the dispropor-
tionate share adjustment percentage described in subsection (c) 
by reason of the COVID–19 public health emergency, but otherwise 
meets the requirements for being a covered entity under subpara-
graph (L), (M), or (O) of subsection (a)(4) of section 340B of the 
Public Health Service Act (42 U.S.C. 256b) and is in compliance 
with all other requirements of the program under such section, 
shall be deemed a covered entity for purposes of such section 
for the period— 
(1) beginning on the date of the enactment of this Act 
(or, if later, with the first of such cost reporting periods for 
which the hospital does not so meet such applicable require-
ment for the disproportionate share adjustment percentage, 
but otherwise meets all other such requirements for being 
such a covered entity and of such program); and
H. R. 2471—745 
(2) ending with the last of such cost reporting periods 
(ending not later than December 31, 2022) for which the hos-
pital does not so meet such applicable requirement for the 
disproportionate share adjustment percentage, but otherwise 
meets all other such requirements for being such a covered 
entity and of such program. 
(b) HOSPITALS.—A hospital described in this subsection is an 
entity that, on the day before the first day of the COVID–19 
public health emergency, was a covered entity described in subpara-
graph (L), (M), or (O) of subsection (a)(4) of section 340B of the 
Public Health Service Act participating in the drug discount pro-
gram under such section. 
(c) APPLICABLE REQUIREMENT FOR DISPROPORTIONATE SHARE 
ADJUSTMENT PERCENTAGE.—The applicable requirement for the dis-
proportionate share adjustment percentage described in this sub-
section is— 
(1) in the case of a hospital described in subsection (a) 
that otherwise meets the requirements under subparagraph 
(L) or (M) of section 340B(a)(4) of the Public Health Service 
Act, the requirement under subparagraph (L)(ii) of such section; 
and 
(2) in the case of a hospital described in subsection (a) 
that otherwise meets the requirements under subparagraph 
(O) of such section 340B(a)(4), the requirement with respect 
to the disproportionate share adjustment percentage described 
in such subparagraph (O). 
(d) SELF-ATTESTATION.— 
(1) IN GENERAL.—A hospital described in subsection (a) 
that fails to meet the applicable requirement for the dispropor-
tionate share adjustment percentage described in subsection 
(c) shall, within 30 days of such failure, or in the case of 
a hospital where such failure occurred prior to the date of 
enactment of this Act but after the start of the COVID-19 
public health emergency, within 30 days of the date of enact-
ment, provide to the Secretary of Health and Human Services 
an attestation that contains information on any actions taken 
by or other impact on such hospital in response to or as a 
result of the COVID-19 public health emergency that may 
have impacted the ability to meet the applicable requirement 
for the disproportionate share adjustment percentage described 
in subsection (c). 
(2) PAPERWORK REDUCTION ACT.—Chapter 35 of title 44, 
United States Code, shall not apply to the collection of informa-
tion provided pursuant to this subsection. 
(e) DEFINITIONS.—In this section: 
(1) COVERED ENTITY.—The term ‘‘covered entity’’ has the 
meaning given such term in section 340B(a)(4) of the Public 
Health Service Act (42 U.S.C. 256b(a)(4)). 
(2) COVID–19 
PUBLIC
HEALTH
EMERGENCY.—The term 
‘‘COVID–19 public health emergency’’ means the public health 
emergency declared by the Secretary of Health and Human 
Services under section 319 of the Public Health Service Act 
(42 U.S.C. 247d) on January 31, 2020, with respect to COVID– 
19 (or any renewal of such declaration).
H. R. 2471—746 
Subtitle D—Maternal Health Quality 
Improvement 
CHAPTER 1—IMPROVEMENTS TO MATERNAL HEALTH 
CARE 
SEC. 131. INNOVATION FOR MATERNAL HEALTH. 
Title III of the Public Health Service Act (42 U.S.C. 241 et 
seq.) is amended by inserting after section 330N of such Act, the 
following: 
‘‘SEC. 330O. INNOVATION FOR MATERNAL HEALTH. 
‘‘(a) IN GENERAL.—The Secretary, in consultation with experts 
representing a variety of clinical specialties, State, Tribal, or local 
public health officials, researchers, epidemiologists, statisticians, 
and community organizations, shall establish or continue a program 
to award competitive grants to eligible entities for the purpose 
of— 
‘‘(1) identifying, developing, or disseminating best practices 
to improve maternal health care quality and outcomes, improve 
maternal and infant health, and eliminate preventable 
maternal mortality and severe maternal morbidity, which may 
include— 
‘‘(A) information on evidence-based practices to improve 
the quality and safety of maternal health care in hospitals 
and other health care settings of a State or health care 
system by addressing topics commonly associated with 
health complications or risks related to prenatal care, labor 
care, birthing, and postpartum care; 
‘‘(B) best practices for improving maternal health care 
based on data findings and reviews conducted by a State 
maternal mortality review committee that address topics 
of relevance to common complications or health risks 
related to prenatal care, labor care, birthing, and 
postpartum care; and 
‘‘(C) information on addressing determinants of health 
that impact maternal health outcomes for women before, 
during, and after pregnancy; 
‘‘(2) collaborating with State maternal mortality review 
committees to identify issues for the development and 
implementation 
of 
evidence-based 
practices 
to 
improve 
maternal health outcomes and reduce preventable maternal 
mortality and severe maternal morbidity, consistent with sec-
tion 317K; 
‘‘(3) providing technical assistance and supporting the 
implementation of best practices identified in paragraph (1) 
to entities providing health care services to pregnant and 
postpartum women; and 
‘‘(4) identifying, developing, and evaluating new models 
of care that improve maternal and infant health outcomes, 
which may include the integration of community-based services 
and clinical care. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible for a grant under sub-
section (a), an entity shall—
H. R. 2471—747 
‘‘(1) submit to the Secretary an application at such time, 
in such manner, and containing such information as the Sec-
retary may require; and 
‘‘(2) demonstrate in such application that the entity is 
capable of carrying out data-driven maternal safety and quality 
improvement initiatives in the areas of obstetrics and gyne-
cology or maternal health. 
‘‘(c) REPORT.—Not later than September 30, 2025, and every 
2 years thereafter, the Secretary shall submit a report to Congress 
on the practices described in paragraphs (1) and (2) of subsection 
(a). Such report shall include a description of the extent to which 
such practices reduced preventable maternal mortality and severe 
maternal morbidity, and whether such practices improved maternal 
and infant health. The Secretary shall disseminate information 
on such practices, as appropriate. 
‘‘(d) AUTHORIZATION
OF APPROPRIATIONS.—To carry out this 
section, there are authorized to be appropriated $9,000,000 for 
each of fiscal years 2023 through 2027.’’. 
SEC. 132. TRAINING FOR HEALTH CARE PROVIDERS. 
Title VII of the Public Health Service Act is amended by 
striking section 763 (42 U.S.C. 294p) and inserting the following: 
‘‘SEC. 763. TRAINING FOR HEALTH CARE PROVIDERS. 
‘‘(a) GRANT PROGRAM.—The Secretary shall establish a program 
to award grants to accredited schools of allopathic medicine, osteo-
pathic medicine, and nursing, and other health professional training 
programs for the training of health care professionals to improve 
the provision of prenatal care, labor care, birthing, and postpartum 
care for racial and ethnic minority populations, including with 
respect to perceptions and biases that may affect the approach 
to, and provision of, care. 
‘‘(b) ELIGIBILITY.—To be eligible for a grant under subsection 
(a), an entity described in such subsection shall submit to the 
Secretary an application at such time, in such manner, and con-
taining such information as the Secretary may require. 
‘‘(c) REPORTING REQUIREMENTS.— 
‘‘(1) PERIODIC GRANTEE REPORTS.—Each entity awarded a 
grant under this section shall periodically submit to the Sec-
retary a report on the status of activities conducted using 
the grant, including a description of the impact of such training 
on patient outcomes, as applicable. 
‘‘(2) REPORT TO CONGRESS.—Not later than September 30, 
2026, the Secretary shall submit a report to Congress on the 
activities conducted using grants under subsection (a) and any 
best practices identified and disseminated under subsection 
(d). 
‘‘(d) BEST PRACTICES.—The Secretary may identify and dissemi-
nate best practices for the training described in subsection (a). 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this sec-
tion, there are authorized to be appropriated $5,000,000 for each 
of fiscal years 2023 through 2027.’’. 
SEC. 133. STUDY ON IMPROVING TRAINING FOR HEALTH CARE PRO-
VIDERS. 
Not later than 2 years after date of enactment of this Act, 
the Secretary of Health and Human Services shall, through a con-
tract with an independent research organization, conduct a study