I 
119TH CONGRESS 
1ST SESSION H. R. 3365 
To amend title XIX of the Social Security Act to provide States with the 
option to provide coordinated care through a pregnancy medical home 
for high-risk pregnant women, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 13, 2025 
Mr. NUNN of Iowa (for himself, Ms. PRESSLEY, and Ms. UNDERWOOD) intro-
duced 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 provide 
States with the option to provide coordinated care 
through a pregnancy medical home for high-risk preg-
nant women, and for other purposes. 
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 ‘‘Harnessing Effective 
and Appropriate Long-Term Health for Moms On Med-
icaid Act of 2025’’ or the ‘‘HEALTH for MOM Act of 
2025’’. 
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SEC. 2. STATE OPTION TO PROVIDE COORDINATED CARE 
THROUGH A HEALTH HOME FOR PREGNANT 
AND POSTPARTUM WOMEN. 
Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended by inserting after section 1945A the 
following new section: 
‘‘SEC. 1945B. STATE OPTION TO PROVIDE COORDINATED 
CARE THROUGH A HEALTH HOME FOR PREG-
NANT AND POSTPARTUM WOMEN. 
‘‘(a) STATE OPTION.— 
‘‘(1) IN
GENERAL.—Notwithstanding section 
1902(a)(1) (relating to statewideness) and section 
1902(a)(10)(B) (relating to comparability), begin-
ning 2 years after the date of the enactment of this 
section, a State, at its option as a State plan amend-
ment and after consultation with health care pro-
viders and individuals enrolled under such plan who 
are or have been pregnant, may provide for medical 
assistance under this title to an eligible woman who 
chooses to— 
‘‘(A) enroll in a maternity health home 
under this section by selecting a designated pro-
vider, a team of health care professionals oper-
ating with such a provider, or a health team as 
the woman’s maternity health home for pur-
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be deemed to be described in such subpara-
graph through the earlier of— 
‘‘(i) the end of the month in which the 
individual’s eligibility for medical assist-
ance under the State plan (or waiver) 
ends; and 
‘‘(ii) the last day of the 1-year period 
that begins on the last day of the individ-
ual’s pregnancy. 
‘‘(C) EXCLUSION OF INDIVIDUALS ELIGI-
BLE
FOR
A
LIMITED
PREGNANCY-RELATED 
ONLY BENEFIT PACKAGE.—Such term does not 
include an individual who had a pregnancy end 
within the last 365 days and whose eligibility 
under such plan (or waiver) is limited to cov-
erage for a limited type of benefits and services. 
‘‘(b) QUALIFICATION STANDARDS.—The Secretary 
shall establish standards for qualification as a maternity 
health home or as a designated provider, team of health 
care professionals operating with such a provider, or a 
health team eligible for participation in a maternity health 
home for purposes of this section. Such standards shall 
include requiring designated providers, teams of health 
care professionals operating with such providers, and 
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health teams (designated as a maternity health home) to 
demonstrate to the State the ability to do the following: 
‘‘(1) Coordinate prompt care and access to ma-
ternity and postpartum care services, including serv-
ices provided by specialists, and programs for an eli-
gible woman during pregnancy and during the pe-
riod for which she remains eligible as described in 
subsection (a)(2)(B). 
‘‘(2) Develop an individualized, comprehensive, 
patient-centered care plan for each eligible woman 
that accommodates patient preferences and, if appli-
cable, reflects adjustments to the payment method-
ology described in subsection (c)(2)(B). 
‘‘(3) Develop and incorporate into each eligible 
woman’s care plan, in a culturally and linguistically 
appropriate manner consistent with the needs of the 
eligible woman, ongoing home care, community- 
based primary care, inpatient care, social support 
services, behavioral health services, local hospital 
emergency care, oral health care, and to the extent, 
applicable, care management and planning related to 
a change in an eligible woman’s eligibility for med-
ical assistance or a change in health insurance cov-
erage. 
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‘‘(4) Coordinate with pediatric care providers, 
community-based providers, behavioral health pro-
viders, social service providers, local hospital and 
emergency care providers, oral health providers, spe-
cialists, and providers of early intervention services 
to ensure full implementation of the client’s care 
plan, as appropriate. 
‘‘(5) Collect and report information under sub-
section (f)(1). 
‘‘(c) PAYMENTS.— 
‘‘(1) IN GENERAL.—A State shall provide a des-
ignated provider, a team of health care professionals 
operating with such a provider, or a health team 
with payments for the provision of pregnancy and 
postpartum coordinated care services, to each eligi-
ble woman that selects such provider, team of health 
care professionals, or health team as the woman’s 
maternity health home or care provider. Payments 
made to a maternity health home or care provider 
for such services shall be treated as medical assist-
ance for purposes of section 1903(a), except that, 
during the first 4 fiscal year quarters that the State 
plan amendment is in effect, the Federal medical as-
sistance percentage applicable to such payments 
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shall be increased by 15 percentage points, but in no 
case may exceed 90 percent. 
‘‘(2) METHODOLOGY.—The State shall specify 
in the State plan amendment the methodology the 
State will use for determining payment for the provi-
sion of pregnancy and postpartum coordinated care 
services or treatment to an eligible woman. Such 
methodology for determining payment— 
‘‘(A) may be based on— 
‘‘(i) a per-member per-month basis for 
each eligible woman enrolled in the mater-
nity health home; 
‘‘(ii) a prospective payment model, in 
the case of payments to Federally qualified 
health centers or a rural health clinics; or 
‘‘(iii) an alternate model of payment 
(which may include a model developed 
under a waiver under section 1115) pro-
posed by the State and approved by the 
Secretary; 
‘‘(B) may be adjusted to reflect, with re-
spect to each eligible woman— 
‘‘(i) the severity of the risks associ-
ated with the woman’s pregnancy; 
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‘‘(ii) the severity of the risks associ-
ated with the woman’s postpartum health 
care needs; and 
‘‘(iii) the level or amount of time of 
care coordination required with respect to 
the woman; and 
‘‘(C) shall be established consistent with 
section 1902(a)(30)(A). 
‘‘(d) COORDINATING CARE.— 
‘‘(1) HOSPITAL NOTIFICATION.—A State with a 
State plan amendment approved under this section 
shall require each hospital that is a participating 
provider under the State plan (or under a waiver of 
such plan) to establish procedures in the case of an 
eligible woman who seeks treatment in the emer-
gency department of such hospital for— 
‘‘(A) providing the woman with culturally 
and linguistically appropriate information on 
the respective treatment models and opportuni-
ties for the woman to access a maternity health 
home and its associated benefits; and 
‘‘(B) notifying the maternity health home 
in which the woman is enrolled, or the des-
ignated provider, team of health care profes-
sionals operating with such a provider, or 
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health team treating the woman, of the wom-
an’s treatment in the emergency department 
and of the protocols for the maternity health 
home, designated provider, or team to be in-
volved in the woman’s emergency care or post- 
discharge care. 
‘‘(2) EDUCATION
WITH
RESPECT
TO
AVAIL-
ABILITY OF A MATERNITY HEALTH HOME.— 
‘‘(A) IN GENERAL.—In order for a State 
plan amendment to be approved under this sec-
tion, a State shall include in the State plan 
amendment a description of the State’s process 
for— 
‘‘(i) educating providers participating 
in the State plan (or a waiver of such 
plan) on the availability of maternity 
health homes for eligible women, including 
the process by which such providers can 
participate in or refer eligible women to an 
approved maternity health home or a des-
ignated provider, team of health care pro-
fessionals operating with such a provider, 
or health team; and 
‘‘(ii) educating eligible women, in a 
culturally and linguistically appropriate 
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manner, on the availability of maternity 
health homes. 
‘‘(B) OUTREACH.—The process established 
by the State under subparagraph (A) shall in-
clude the participation of relevant stakeholders 
or other public or private organizations or enti-
ties that provide outreach and information on 
the availability of health care items and services 
to families of individuals eligible to receive med-
ical assistance under the State plan (or a waiv-
er of such plan). 
‘‘(3) MENTAL
HEALTH
COORDINATION.—A 
State with a State plan amendment approved under 
this section shall consult and coordinate, as appro-
priate, with the Secretary in addressing issues re-
garding the prevention, identification, and treatment 
of mental health conditions and substance use dis-
orders among eligible women. 
‘‘(4) COORDINATION OF SOCIAL AND SUPPORT 
SERVICES.—A State with a State plan amendment 
approved under this section shall consult and coordi-
nate, as appropriate, with the Secretary in estab-
lishing means to connect eligible women receiving 
pregnancy and postpartum care coordinated under 
this section with social and support services, includ-
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ing services made available under maternal, infant, 
and early childhood home visiting programs estab-
lished under section 511, and services made avail-
able under section 330H or title X of the Public 
Health Service Act, the Special Supplemental Nutri-
tion Program for Women, Infants, and Children, or 
under title V. 
‘‘(e) MONITORING.—A State shall include in the 
State plan amendment— 
‘‘(1) a methodology for tracking reductions in 
inpatient days and reductions in the total cost of 
care resulting from improved care coordination and 
management under this section; 
‘‘(2) a proposal for use of health information 
technology in providing an eligible woman with preg-
nancy and postpartum coordinated care services as 
specified under this section and improving service 
delivery and coordination across the care continuum; 
and 
‘‘(3) a methodology for tracking prompt and 
timely access to medically necessary care for eligible 
women from out-of-State providers. 
‘‘(f) DATA COLLECTION.— 
‘‘(1) PROVIDER REPORTING REQUIREMENTS.— 
In order to receive payments from a State under 
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subsection (c), a maternity health home, or a des-
ignated provider, a team of health care professionals 
operating with such a provider, or a health team, 
shall report to the State, at such time and in such 
form and manner as may be required by the State, 
including through a health information exchange or 
other public health data sharing entity, the following 
information: 
‘‘(A) With respect to each such designated 
provider, team of health care professionals oper-
ating with such a provider, and health team 
(designated as a maternity health home), the 
name, National Provider Identification number, 
address, and specific health care services of-
fered to be provided to eligible women who have 
selected such provider, team of health care pro-
fessionals, or health team as the womens mater-
nity health home. 
‘‘(B) Information on all applicable meas-
ures for determining the quality of services pro-
vided by such provider, team of health care pro-
fessionals, or health team, including, to the ex-
tent applicable, maternal, perinatal, and child 
health quality measures under section 1139B. 
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‘‘(C) Such other information as the Sec-
retary shall specify in guidance. 
‘‘(2) STATE REPORTING REQUIREMENTS.— 
‘‘(A) COMPREHENSIVE REPORT.—A State 
with a State plan amendment approved under 
this section shall report to the Secretary (and, 
upon request, to the Medicaid and CHIP Pay-
ment and Access Commission), at such time, 
but at a minimum frequency of every 12 
months, and in such form and manner deter-
mined by the Secretary to be reasonable and 
minimally burdensome, including through a 
health information exchange or other public 
health data sharing entity, the following infor-
mation: 
‘‘(i) Information described in para-
graph (1). 
‘‘(ii) The number and, to the extent 
available and while maintaining all relevant 
protecting privacy and confidentially pro-
tections, disaggregated demographic infor-
mation of eligible women who have enrolled 
in a maternity health home pursuant to 
this section. 
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‘‘(iii) The number of maternity health 
homes in the State. 
‘‘(iv) The medical and behavioral 
health conditions or factors that contribute 
to severe maternal morbidity among eligi-
ble women enrolled in maternity health 
homes in the State. 
‘‘(v) The extent to which such women 
receive health care items and services 
under the State plan before, during, and 
after the women’s enrollment in such a 
maternity health home. 
‘‘(vi) Where applicable, mortality data 
and data for the associated causes of death 
for eligible women enrolled in a maternity 
health home under this section, in accord-
ance with subsection (g). For deaths occur-
ring postpartum, such data shall distin-
guish between deaths occurring up to 42 
days postpartum and deaths occurring be-
tween 43 days to up to 1 year postpartum. 
Where applicable, data reported under this 
clause shall be reported alongside com-
parable data from a State’s maternal mor-
tality review committee, as established in 
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accordance with section 317K(d) of the 
Public Health Service Act, for purposes of 
further identifying and comparing state-
wide trends in maternal mortality among 
populations participating in the maternity 
health home under this section. 
‘‘(vii) The type of delivery systems 
and payment models used to provide health 
home services to eligible individuals en-
rolled in a maternal health home under 
such amendment. 
‘‘(viii) Information on hospitalizations, 
morbidity, and mortality of eligible individ-
uals and their infants enrolled in a mater-
nal health home in such State alongside 
comparable data from a State’s maternal 
mortality review committee. 
‘‘(B) 
IMPLEMENTATION
REPORT.—Not 
later than 18 months after a State has a State 
plan amendment approved under this section, 
the State shall submit to the Secretary, and 
make publicly available on the appropriate 
State website, a report on how the State is im-
plementing the option established under this 
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section, including through any best practices 
adopted by the State. 
‘‘(g) CONFIDENTIALITY.—A State with a State plan 
amendment under this section shall establish confiden-
tiality protections for the purposes of subsection (f)(2)(A) 
to ensure, at a minimum, that there is no disclosure by 
the State of any identifying information about any specific 
eligible woman enrolled in a maternity health home or any 
maternal mortality case, and that all relevant confiden-
tiality and privacy protections, including the requirements 
under 1902(a)(7)(A), are maintained. 
‘‘(h) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require— 
‘‘(1) an eligible woman to enroll in a maternity 
health home under this section; or 
‘‘(2) a designated provider or health team to 
act as a maternity health home and provide services 
in accordance with this section if the provider or 
health team does not voluntarily agree to act as a 
maternity health home. 
‘‘(i) PLANNING GRANTS.— 
‘‘(1) IN
GENERAL.—Beginning October 1, 
2025, from the amount appropriated under para-
graph (2), the Secretary shall award planning grants 
to States for purposes of developing and submitting 
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a State plan amendment under this section. The 
Secretary shall award a grant to each State that ap-
plies for a grant under this subsection, but the Sec-
retary may determine the amount of the grant based 
on the merits of the application and the goal of the 
State to prioritize health outcomes for eligible 
women. A planning grant awarded to a State under 
this subsection shall remain available until expended. 
‘‘(2) APPROPRIATION.—There are authorized to 
be appropriated to the Secretary $50,000,000 for 
the 2-year period beginning on the date of the enact-
ment of this section, for the purposes of making 
grants under this subsection, to remain available 
until expended. 
‘‘(3) LIMITATION.—The total amount of pay-
ments made to States under this subsection shall not 
exceed $50,000,000. 
‘‘(j) ADDITIONAL DEFINITIONS.—In this section: 
‘‘(1) DESIGNATED PROVIDER.—The term ‘des-
ignated provider’ means a physician (including an 
obstetrician-gynecologist), hospital, clinical practice 
or clinical group practice, rural clinic, community 
health center, community mental health center, or 
any other entity or provider that is determined by 
the State and approved by the Secretary to be quali-
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fied to be a maternity health home on the basis of 
documentation evidencing that the entity has the 
systems, expertise, and infrastructure in place to 
provide pregnancy and postpartum coordinated care 
services. Such term may include providers who are 
employed by, or affiliated with, a hospital. 
‘‘(2) MATERNITY
HEALTH
HOME.—The term 
‘maternity health home’ means a designated provider 
(including a provider that operates in coordination 
with a team of health care professionals) or a health 
team is selected by an eligible woman to provide 
pregnancy and postpartum coordinated care services. 
‘‘(3) HEALTH TEAM.—The term ‘health team’ 
has the meaning given such term for purposes of 
section 3502 of Public Law 111–148. 
‘‘(4) PREGNANCY
AND
POSTPARTUM
COORDI-
NATED CARE SERVICES.— 
‘‘(A) IN GENERAL.—The term ‘pregnancy 
and postpartum coordinated care services’ 
means items and services related to the coordi-
nation of care for comprehensive and timely 
high-quality, culturally and linguistically appro-
priate, services described in subparagraph (B) 
that are provided to an eligible woman by a 
designated provider, a team of health care pro-
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fessionals operating with such a provider, or a 
health team (designated as a maternity health 
home). 
‘‘(B) SERVICES DESCRIBED.— 
‘‘(i) IN GENERAL.—The services de-
scribed in this subparagraph shall include 
with respect to a State electing the State 
plan amendment option under this section, 
any medical assistance for items and serv-
ices for which payment is available under 
the State plan or under a waiver of such 
plan. 
‘‘(ii) OTHER ITEMS AND SERVICES.— 
In addition to medical assistance described 
in clause (i), the services described in this 
subparagraph shall include the following: 
‘‘(I) Comprehensive care manage-
ment. 
‘‘(II) Care coordination (includ-
ing with pediatricians, specialists, and 
providers of early intervention serv-
ices, as appropriate), health pro-
motion, and providing access to the 
full range of maternal, obstetric, and 
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gynecologic services, including services 
from out-of-State providers. 
‘‘(III) Comprehensive transitional 
care, including appropriate follow-up, 
from inpatient to other settings. 
‘‘(IV) Patient and family support 
(including authorized representatives). 
‘‘(V) Referrals to community and 
social support services, if relevant. 
‘‘(VI) Use of health information 
technology to link services, as feasible 
and appropriate. 
‘‘(5) 
TEAM
OF
HEALTH
CARE
PROFES-
SIONALS.—The term ‘team of health care profes-
sionals’ means a team of health care professionals 
(as described in the State plan amendment under 
this section) that may— 
‘‘(A) include— 
‘‘(i) physicians, including gynecologist- 
obstetricians, pediatricians, and other pro-
fessionals such as physicians assistants, 
advance practice nurses, including certified 
midwives, nurses, nurse care coordinators, 
dietitians, nutritionists, social workers, be-
havioral 
health 
professionals, 
physical 
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