(ii) by striking ‘‘shall also make the 
election’’ and inserting ‘‘the State shall 
provide coverage’’. 
(b) CHIP.— 
(1) IN GENERAL.—Subparagraph (K) of section 
2107(e)(1) of the Social Security Act (42 U.S.C. 
1397gg(e)(1)), as redesignated by section 105, is 
amended to read as follows: 
‘‘(K) Paragraphs (5) and (16) of section 
1902(e) (relating to the requirement to provide 
medical assistance under the State plan or 
waiver consisting of full benefits during preg-
nancy and throughout the 12-month period that 
begins on the last day of the individual’s preg-
nancy and ends on the last day of the month 
in which such 12-month period ends).’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
2112(d)(2)(A) of the Social Security Act (42 U.S.C. 
1397ll(d)(2)(A)) is amended by striking ‘‘the month 
in which the 60-day period’’ and all that follows 
through ‘‘pursuant to section 2107(e)(1),’’. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraphs (2) 
and (3), the amendments made by subsections (a) 
and (b) shall take effect on the 1st day of the 1st 
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calendar quarter that begins on or after the date 
that is 1 year after the date of enactment of this 
Act. 
(2) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State plan under title XIX of the So-
cial Security Act or a State child health plan under 
title XXI of such Act that the Secretary of Health 
and Human Services determines requires State legis-
lation in order for the respective plan to meet any 
requirement imposed by amendments made by this 
subsection, the respective plan shall not be regarded 
as failing to comply with the requirements of such 
title solely on the basis of its failure to meet such 
an additional requirement before the 1st day of the 
1st calendar quarter beginning after the close of the 
1st regular session of the State legislature that be-
gins after the date of enactment of this Act. For 
purposes of the previous sentence, in the case of a 
State that has a 2-year legislative session, each year 
of the session shall be considered to be a separate 
regular session of the State legislature. 
(3) STATE
OPTION
FOR
EARLIER
EFFECTIVE 
DATE.—A State may elect to have subsection (e)(16) 
of section 1902 of the Social Security Act (42 
U.S.C. 1396a) and subparagraph (K) of section 
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2107(e)(1) of the Social Security Act (42 U.S.C. 
1397gg(e)(1)), as redesignated by section 105 and 
amended by subsection (b) of this section, take ef-
fect with respect to the State on the 1st day of any 
fiscal quarter that begins before the date described 
in paragraph (1) and apply to amounts payable to 
the State for expenditures for medical assistance, 
child health assistance, or pregnancy-related assist-
ance to pregnant or postpartum individuals fur-
nished on or after such day. 
SEC. 
202. 
HEALTH 
HOMES 
FOR 
PREGNANT 
AND 
POSTPARTUM WOMEN. 
(a) MEDICAID.—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 INDIVIDUALS. 
‘‘(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 January 1, 2028, a State, at its option as a 
State plan amendment, may provide for medical as-
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sistance under this title to an eligible individual 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 individual’s maternity health home for pur-
poses of providing the individual with preg-
nancy and postpartum coordinated care serv-
ices; or 
‘‘(B) receive such services from a des-
ignated provider, a team of health care profes-
sionals operating with such a provider, or a 
health team that has voluntarily opted to par-
ticipate in a maternity health home for eligible 
individuals under this section. 
‘‘(2) ELIGIBLE INDIVIDUAL DEFINED.—In this 
section, the term ‘eligible individual’ means an indi-
vidual— 
‘‘(A) who is eligible for medical assistance 
under the State plan (or under a waiver of such 
plan) for all items and services covered under 
the State plan (or under a waiver of such plan); 
‘‘(B) who is not enrolled in a health home 
under section 1945 or 1945A; and 
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‘‘(C) either— 
‘‘(i) who is pregnant; or 
‘‘(ii) whose pregnancy has ended and 
is within the 12-month period that begins 
on the last day of the individual’s preg-
nancy and ends on the last day of the 
month in which such 12-month period 
ends. 
‘‘(b) QUALIFICATION STANDARDS.—The Secretary 
shall establish standards for qualification as a maternity 
health home or as a designated provider, a 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. In establishing such 
standards, the Secretary shall consider best practices and 
models of care used by recipients of grants under section 
330P of the Public Health Service Act. Such standards 
shall include requiring a designated provider, a team of 
health care professionals operating with such a provider, 
and a health team designated as a maternity health home 
to demonstrate to the State the ability to do the following: 
‘‘(1) Coordinate prompt care and access to nec-
essary maternity care services, including services 
provided by specialists, and programs for an eligible 
individual during the individual’s pregnancy and the 
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365-day period beginning on the last day of such 
pregnancy. 
‘‘(2) Develop an individualized, comprehensive, 
patient-centered care plan for each eligible individual 
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 
individual’s care plan, in a culturally and linguis-
tically appropriate manner consistent with the needs 
of the eligible individual, ongoing home care, com-
munity-based primary care, inpatient care, social 
support services, health-related social needs services, 
behavioral health services, local hospital emergency 
care, and, in the event of a change in income that 
would result in the eligible individual losing eligi-
bility for medical assistance under the State plan (or 
under a waiver of such plan), care management and 
planning related to a change in the eligible individ-
ual’s health insurance coverage. 
‘‘(4) Coordinate with pediatric care providers, 
as appropriate. 
‘‘(5) Collect and report information under sub-
section (f)(1). 
‘‘(c) PAYMENTS.— 
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‘‘(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 
designated as a maternity health home with pay-
ments for the provision of health home services to 
each eligible individual that selects such provider, 
team of health care professionals, or health team as 
the eligible individual’s health home. Payments made 
to a designated provider, a team of health care pro-
fessionals operating with such a provider, or a health 
team for such services shall be treated as medical 
assistance for purposes of section 1903(a), except 
that, during the first 8 fiscal year quarters that the 
State plan amendment is in effect, the Federal med-
ical assistance percentage applicable to such pay-
ments shall be equal to 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 during an eligible individual’s 
pregnancy and the 365-day period beginning on the 
last day of such pregnancy. Such methodology for 
determining payment— 
‘‘(A) may be based on— 
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‘‘(i) a per-member per-month basis for 
each eligible individual enrolled in a 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 
proposed by the State and approved by the 
Secretary; 
‘‘(B) may be adjusted to reflect, with re-
spect to each eligible individual— 
‘‘(i) the severity of the risks associ-
ated with the individual’s pregnancy; 
‘‘(ii) the severity of the risks associ-
ated with the individual’s postpartum 
health care needs; and 
‘‘(iii) the level or amount of time of 
care coordination required with respect to 
the individual; 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 
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provider under the State plan (or under a waiver of 
such plan) to establish procedures in the case of an 
eligible individual who seeks treatment in the emer-
gency department of such hospital for— 
‘‘(A) providing the individual with cul-
turally and linguistically appropriate informa-
tion supplied by the State describing the respec-
tive treatment models and opportunities for the 
individual to access a maternity health home 
and its associated benefits; and 
‘‘(B) notifying the maternity health home 
in which the individual is enrolled, or the des-
ignated provider, team of health care profes-
sionals operating with such a provider, or 
health team treating the individual, of the indi-
vidual’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 individual’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 
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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 individuals, in-
cluding the process by which such pro-
viders can participate in or refer an eligible 
individual to an approved maternity health 
home or a designated provider, team of 
health care professionals operating such a 
provider, or health team designated as a 
maternity health home; and 
‘‘(ii) educating eligible individuals, in 
a culturally and linguistically appropriate 
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 entities or other pub-
lic or private organizations or entities that pro-
vide outreach and information on the avail-
ability of health care items and services to fami-
lies of individuals eligible to receive medical as-
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sistance under the State plan (or a waiver 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 individuals. 
‘‘(4) SOCIAL AND SUPPORT SERVICES.—A State 
with a State plan amendment approved under this 
section shall consult and coordinate, as appropriate, 
with the Secretary in establishing means to connect 
eligible 
individuals 
receiving 
pregnancy 
and 
postpartum coordinated care services under this sec-
tion with social and support services, including serv-
ices made available under maternal, infant, and 
early childhood home visiting programs established 
under section 511 and services made available under 
section 330H or title X of the Public Health Service 
Act. 
‘‘(5) COORDINATION
WITH
GRANT
PROGRAM 
FOR
INTEGRATED
SERVICES
FOR
PREGNANT
AND 
POSTPARTUM WOMEN.—A State with a State plan 
amendment approved under this section shall consult 
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and coordinate, as appropriate, with the Secretary 
with respect to the provision of medical assistance to 
eligible individuals enrolled in a maternity health 
home under this section and grantees delivering inte-
grated health care services to pregnant and 
postpartum women under section 330P of the Public 
Health Service Act (including, if applicable, the 
State). 
‘‘(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 individual with 
pregnancy 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 
individuals from out-of-State providers. 
‘‘(f) DATA COLLECTION.— 
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‘‘(1) PROVIDER REPORTING REQUIREMENTS.— 
In order to receive payments from a State under 
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 
designated as a maternity health home, 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 pub-
lic health data sharing entity, the following informa-
tion: 
‘‘(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 any eligible individual 
who has selected such provider, team of health 
care professionals, or health team as the eligible 
individual’s maternity health home. 
‘‘(B) Information on all other applicable 
measures for determining the quality of services 
provided by such provider, team of health care 
professionals, or health team. 
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‘‘(C) Information concerning the factors 
described in paragraph (2)(A)(vi) received from 
health risk assessments of eligible individuals 
conducted and completed by the designated pro-
vider, team of health care professionals oper-
ating with such a provider, or health team des-
ignated as a maternity health home. 
‘‘(D) 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 annually, and in such form 
and manner determined by the Secretary to be 
reasonable and minimally burdensome, the fol-
lowing information: 
‘‘(i) Information described in para-
graph (1). 
‘‘(ii) The number and, to the extent 
available and while maintaining all relevant 
privacy 
and 
confidentially 
protections, 
disaggregated 
demographic 
information 
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(including information on geography) of el-
igible individuals who have enrolled in a 
maternity health home pursuant to this 
section. 
‘‘(iii) The number of maternity health 
homes in the State designated under this 
section. 
‘‘(iv) The medical conditions or fac-
tors that contribute to severe maternal 
morbidity among eligible individuals en-
rolled in maternity health homes in the 
State. 
‘‘(v) The extent to which such individ-
uals receive health care items and services 
under the State plan before, during, and 
after an individual’s enrollment in such a 
maternity health home. 
‘‘(vi) Where applicable, mortality data 
and data for the associated causes of preg-
nancy-related death for eligible individuals 
enrolled in a maternity health home under 
this section, in accordance with subsection 
(g). For deaths occurring postpartum, such 
data shall distinguish between deaths oc-
curring up to 42 days postpartum and 
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deaths occurring between 43 days to up to 
1 year postpartum. Where applicable, data 
reported under this clause shall be re-
ported alongside comparable data from a 
State’s maternal mortality review com-
mittee, as established in accordance with 
section 317K(d) of the Public Health Serv-
ice Act, for purposes of further identifying 
and comparing statewide trends in mater-
nal mortality among populations partici-
pating in the maternity health home under 
this section. 
‘‘(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 
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 
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the State of any identifying information about any specific 
eligible individual enrolled in a maternity health home or 
any maternal mortality case, and that all relevant con-
fidentiality and privacy protections, including the require-
ments under section 1902(a)(7)(A), are maintained. 
‘‘(h) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require— 
‘‘(1) an eligible individual to enroll in a mater-
nity 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 January 1, 
2027, from the amount appropriated under para-
graph (2), the Secretary shall award planning grants 
to States for purposes of developing and submitting 
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 and meets the 
application criteria established by the Secretary, and 
the Secretary may determine the amount of the 
grant based on the merits of the application and the 
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goal of the State to prioritize health outcomes for el-
igible individuals. 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 
fiscal year 2027, for the purposes of making grants 
under this subsection, to remain available until ex-
pended. 
‘‘(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 or, if applicable, a certified 
nurse midwife, or certified professional midwife who 
meets or exceeds the education and training stand-
ards of the International Confederation of Midwives 
and who is licensed to practice within the State), a 
hospital, clinical practice or clinical group practice, 
rural health clinic, community health center, commu-
nity mental health center, or any other entity or pro-
vider that is determined by the State and approved 
by the Secretary to be qualified to be a maternity 
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