(b) CONSULTATION.—In developing the report re-
quired under subsection (a), the Secretary shall consult 
with the advisory committee established under section 
12(c). 
SEC. 16. MEDICAID GUIDANCE ON STATE OPTIONS TO AD-
DRESS SOCIAL DETERMINANTS OF HEALTH 
FOR PREGNANT AND POSTPARTUM WOMEN. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Secretary shall issue 
guidance to States and conduct one or more learning 
collaboratives to promote cross-state learning regarding 
options States may employ to address social determinants 
of health, as defined by the Healthy People 2030 and re-
lated initiatives of the Office of Disease Prevention and 
Health Promotion of the Department of Health and 
Human Services, including for pregnant and postpartum 
women. 
(b) GUIDANCE REQUIREMENTS.—The guidance re-
quired under subsection (a) shall, at a minimum, describe 
the authorities that States may leverage to support ad-
dressing the social determinants of health for pregnant 
and postpartum women and outline best practices for such 
efforts. 
(c) LEARNING COLLABORATIVE REQUIREMENTS.— 
The learning collaboratives required under subsection (a) 
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shall, at a minimum, include opportunities for States and 
other stakeholders to share innovative practices and ap-
proaches as they are being considered and developed, 
share solutions related to challenges that multiple urban 
and rural States face, and promote the uptake of ap-
proved, effective interventions addressing social needs and 
determinants covered by the Medicaid program. 
SEC. 17. PAYMENT ERROR RATE MEASUREMENT (PERM) 
AUDIT AND IMPROVEMENT REQUIREMENTS. 
(a) BIENNIAL PERM AUDIT REQUIREMENT.—Be-
ginning with fiscal year 2025, the Administrator shall con-
duct payment error rate measurement (‘‘PERM’’) audits 
of each State Medicaid program on a biennial basis. 
(b) PERM ERROR RATE REDUCTION PLAN RE-
QUIREMENT.—Beginning with fiscal year 2025, any State 
with an overall PERM error rate exceeding 15 percent in 
a PERM audit conducted with respect to the State in the 
previous fiscal year shall publish a plan, in coordination 
with, and subject to the approval of, the Administrator, 
for how the State will reduce its PERM error rate below 
15 percent in the current fiscal year. 
(c) NOTIFICATION; IDENTIFICATION OF SOURCES OF 
IMPROPER PAYMENTS.— 
(1) NOTIFICATION.—Not later than 6 months 
after the date of enactment of this Act, the Adminis-
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trator shall notify the contractor conducting PERM 
audits of the Administrator’s intent to modify con-
tracts to require PERM audits not less than once 
every other year in each State. 
(2) IDENTIFICATION OF SOURCES OF IMPROPER 
PAYMENTS.—The Administrator shall direct the con-
tractor conducting PERM audits of State Medicaid 
programs to identify areas known to be sources of 
improper payments under such programs to identify 
program areas or components known to be sources 
of high risk for improper payments under such pro-
grams. 
(d) STATE MEDICAID DIRECTOR LETTER.—Not later 
than 12 months after the date of enactment of this Act, 
the Administrator shall issue a State Medicaid Director 
letter regarding State requirements under Federal law and 
regulations regarding avoiding and responding to im-
proper payments under State Medicaid programs. 
(e) 
STATE
IMPROPER
PAYMENT
MITIGATION 
PLANS.— 
(1) IN GENERAL.—Not later than January 1, 
2024, each State Medicaid program shall submit to 
the Administrator a plan, which shall include spe-
cific actions and timeframes for taking such actions 
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and achieving specified results, for mitigating im-
proper payments under such program. 
(2) PUBLICATION OF STATE PLANS.—The Ad-
ministrator shall make State plans submitted under 
paragraph (1) available to the public. 
(f) DEFINITIONS.—In this section: 
(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of the Centers for 
Medicare & Medicaid Services. 
(2) STATE.—The term ‘‘State’’ has the mean-
ing given such term for purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
(3) STATE
MEDICAID
PROGRAM.—The term 
‘‘State Medicaid program’’ means a State plan 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.), and includes any waiver of 
such a plan. 
Æ 
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