(dd) At least 1 representa-
tive from a medical professional 
organization 
representing 
cer-
tified nurse-midwives. 
(ee) At least 1 representa-
tive from a medical professional 
organization representing other 
maternal 
fetal 
medicine 
pro-
viders. 
(ff) At least 1 representative 
from a medical professional orga-
nization representing anesthesiol-
ogists. 
(gg) At least 1 representa-
tive from a medical professional 
organization representing emer-
gency medicine physicians and 
urgent care providers. 
(hh) At least 1 representa-
tive from a medical professional 
organization representing nurses. 
(ii) At least 1 representative 
from a professional organization 
representing community health 
workers. 
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(jj) At least 1 representative 
from a professional organization 
representing doulas. 
(kk) At least 1 representa-
tive from a professional organiza-
tion representing perinatal psy-
chiatrists. 
(ll) At least 1 representative 
from State-affiliated programs or 
existing collaboratives with dem-
onstrated expertise or success in 
improving maternal health. 
(mm) At least 1 director of 
a State Medicaid agency that has 
had demonstrated success in im-
proving maternal health. 
(nn) At least 1 representa-
tive from an accrediting organi-
zation for maternal health quality 
and safety standards. 
(oo) At least 1 representa-
tive from a maternal patient ad-
vocacy organization with lived ex-
perience of severe maternal mor-
bidity. 
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(II) REQUIREMENTS.—Each in-
dividual selected to be a member 
under this clause shall— 
(aa) have expertise in mater-
nal health; 
(bb) not be a Federal offi-
cial; and 
(cc) have experience working 
with populations that are at 
higher risk for maternal mor-
tality or severe morbidity, such 
as populations that experience 
racial, ethnic, and geographic 
health disparities, pregnant and 
postpartum women experiencing 
a mental health disorder, or 
pregnant or postpartum women 
with other comorbidities such as 
substance use disorders, hyper-
tension, thyroid disorders, and 
sickle cell disease. 
(C) ADDITIONAL MEMBERS.— 
(i) IN GENERAL.—In addition to the 
members required to be appointed under 
subparagraph (B), the Secretary may ap-
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point to the Advisory Committee such 
other individuals with relevant expertise or 
experience as the Secretary shall determine 
appropriate, which may include individuals 
described in clause (ii). 
(ii) SUGGESTED
ADDITIONAL
MEM-
BERS.—The individuals described in this 
clause are the following: 
(I) Representatives from State 
maternal mortality review committees 
and perinatal quality collaboratives. 
(II) Medical providers who care 
for women and infants during preg-
nancy and the postpartum period, 
such as family practice physicians, 
cardiologists, 
pulmonology 
critical 
care specialists, endocrinologists, pedi-
atricians, and neonatologists. 
(III) Representatives from State 
and local public health departments, 
including State Medicaid Agencies. 
(IV) Subject matter experts in 
conducting outreach to women who 
are African American or belong to an-
other minority group. 
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(V) Directors of State agencies 
responsible for administering a State’s 
maternal and child health services 
program under title V of the Social 
Security Act (42 U.S.C. 701 et seq.). 
(VI) Experts in medical edu-
cation or physician training. 
(VII) Representatives from Med-
icaid managed care organizations. 
(4) APPLICABILITY OF FACA.—The Federal Ad-
visory Committee Act (5 U.S.C. App.) shall apply to 
the committee established under this subsection. 
(d) CONTENTS.—The guidance described in sub-
section (a) shall include, with respect to hospitals, free-
standing birth centers, and other maternal care providers, 
the following: 
(1) Best practices regarding evidence-based 
screening and clinician education initiatives relating 
to screening and treatment protocols for individuals 
who are at risk of experiencing complications related 
to pregnancy, with an emphasis on individuals with 
preconditions directly linked to pregnancy complica-
tions and maternal mortality and severe morbidity, 
including— 
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(A) methods to identify individuals who are 
at risk of maternal mortality or severe mor-
bidity, including risk stratification; 
(B) evidence-based risk factors associated 
with maternal mortality or severe morbidity and 
racial, ethnic, and geographic health disparities; 
(C) evidence-based strategies to reduce risk 
factors associated with maternal mortality or 
severe morbidity through services which may be 
covered under Medicaid or CHIP, including, 
but not limited to, activities by community 
health workers (as such term is defined in sec-
tion 2113(f)(4) of the Social Security Act (42 
U.S.C. 1397mm(f)(4))) that are funded by a 
grant awarded under such section; 
(D) resources available to such individuals, 
such as nutrition assistance and education, 
home visitation, mental health and substance 
use disorder services, smoking cessation pro-
grams, pre-natal care, and other evidence-based 
maternal mortality or severe morbidity reduc-
tion programs; 
(E) examples of educational materials used 
by providers of obstetrics services; 
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(F) methods for improving community cen-
tralized care, including providing telehealth 
services or home visits to increase and facilitate 
access to and engagement in prenatal and 
postpartum care and collaboration with home 
health agencies, community health centers, local 
public health departments, or clinics; 
(G) guidance on medical record diagnosis 
codes linked to maternal mortality and severe 
morbidity, including, if applicable, codes related 
to social risk factors, and methods for edu-
cating clinicians on the proper use of such 
codes; 
(H) risk appropriate transfer protocols 
during pregnancy, childbirth, and the post-
partum period; and 
(I) any other information related to pre-
vention and treatment of at-risk individuals de-
termined appropriate by the Secretary. 
(2) Guidance on monitoring programs for indi-
viduals who have been identified as at risk of com-
plications related to pregnancy. 
(3) Best practices for such hospitals, free-
standing birth centers, and providers to make preg-
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nant women aware of the complications related to 
pregnancy. 
(4) A fact sheet for providing pregnant women 
who are receiving care on an outpatient basis with 
a notice during the prenatal stage of pregnancy 
that— 
(A) explains the risks associated with preg-
nancy, birth, and the postpartum period (in-
cluding the risks of hemorrhage, preterm birth, 
sepsis, eclampsia, obstructed labor), chronic 
conditions (including high blood pressure, dia-
betes, heart disease, depression, and obesity) 
correlated with adverse pregnancy outcomes, 
risks associated with advanced maternal age, 
and the importance of adhering to a personal-
ized plan of care; 
(B) highlights multimodal and evidence- 
based prevention and treatment techniques; 
(C) provides for a method (through signa-
ture or otherwise) for such an individual, or a 
person acting on such individual’s behalf, to ac-
knowledge receipt of such fact sheet; 
(D) is worded in an easily understandable 
manner and made available in multiple lan-
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guages and accessible formats determined ap-
propriate by the Secretary; and 
(E) includes any other information deter-
mined appropriate by the Secretary. 
(5) A template for a voluntary clinician check-
list that outlines the minimum responsibilities that 
clinicians, such as physicians, certified nurse-mid-
wives, emergency room and urgent care providers, 
nurses and others, are expected to meet in order to 
promote quality and safety in the provision of ob-
stetric services. 
(6) A template for a voluntary checklist that 
outlines the minimum responsibilities that hospital 
leadership responsible for direct patient care, such 
as the institution’s president, chief medical officer, 
chief nursing officer, or other hospital leadership 
that directly report to the president or chief execu-
tive officer of the institution, should meet to pro-
mote hospital-wide initiatives that improve quality 
and safety in the provision of obstetric services. 
(7) Information on multi-stakeholder quality 
improvement initiatives, such as the Alliance for In-
novation on Maternal Health, State perinatal quality 
improvement initiatives, and other similar initiatives 
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determined appropriate by the Secretary, includ-
ing— 
(A) information about such improvement 
initiatives and how to join; 
(B) information about public maternal 
data collection centers; 
(C) information about quality metrics used 
and outcomes achieved by such improvement 
initiatives; 
(D) information about data sharing tech-
niques used by such improvement initiatives; 
(E) information about data sources used 
by such improvement initiatives to identify ma-
ternal mortality and severe morbidity risks; 
(F) information about interventions used 
by such improvement initiatives to mitigate 
risks of maternal mortality and severe mor-
bidity; 
(G) information about data collection tech-
niques on race, ethnicity, geography, age, in-
come, and other demographic information used 
by such improvement initiatives; and 
(H) any other information determined ap-
propriate by the Secretary. 
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(e) INCLUSION OF BEST PRACTICES.—Not later than 
18 months after the date of the publication of the guid-
ance required under subsection (a), the Secretary shall up-
date such guidance to include best practices identified by 
the Secretary for such hospitals, freestanding birth cen-
ters, and providers to track maternal mortality and severe 
morbidity trends by clinicians at such hospitals, free-
standing birth centers, and providers including— 
(1) ways to establish scoring systems, which 
may include quality triggers and safety and quality 
metrics to score case and patient outcome metrics, 
for such clinicians; 
(2) methods to identify, educate, and improve 
such clinicians who may have higher rates of mater-
nal mortality or severe morbidity compared to their 
regional or State peers (taking into account dif-
ferences in patient risk for adverse outcomes, which 
may include social risk factors); 
(3) methods for using such data and tracking 
to enhance research efforts focused on maternal 
health, while also improving patient outcomes, clini-
cian education and training, and coordination of 
care; and 
(4) any other information determined appro-
priate by the Secretary. 
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(f) CULTURAL
AND
LINGUISTIC
APPROPRIATE-
NESS.—To the extent practicable, the Secretary should de-
velop the guidance, best practices, fact sheets, templates, 
and other materials that are required under this section 
in a trauma-informed, culturally and linguistically appro-
priate manner. 
SEC. 3. REPORT ON PAYMENT METHODOLOGIES FOR 
TRANSFERRING 
PREGNANT 
WOMEN 
BE-
TWEEN FACILITIES BEFORE, DURING, AND 
AFTER CHILDBIRTH. 
(a) IN GENERAL.—Subject to the availability of ap-
propriations, not later than 36 months after the date of 
enactment of this Act, the Secretary shall submit to Con-
gress a report on the payment methodologies under Med-
icaid for the antepartum, intrapartum, and postpartum 
transfer of pregnant women from one health care facility 
to another, including any potential disincentives or regu-
latory barriers to such transfers. 
(b) CONSULTATION.—In developing the report re-
quired under subsection (a), the Secretary shall consult 
with the advisory committee established under section 
2(c). 
Æ 
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