(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Quality measures for maternity care under Medicaid and CHIP. 
Sec. 3. Quality collaboratives. 
Sec. 4. Woman- and family-centered maternity care home demonstration pro-
gram. 
SEC. 2. QUALITY MEASURES FOR MATERNITY CARE UNDER 
MEDICAID AND CHIP. 
(a) IN GENERAL.—Title XI of the Social Security Act 
is amended by inserting after section 1139B (42 U.S.C. 
1320b–9b) the following new section: 
‘‘SEC. 1139C. MATERNITY CARE QUALITY MEASUREMENT. 
‘‘(a) IN GENERAL.—The Secretary shall develop a 
maternity care quality measurement program for care pro-
vided to childbearing women and newborns for voluntary 
use by— 
‘‘(1) a State in administering a State plan 
under title XIX or a State child health plan under 
title XXI; 
‘‘(2) health insurance issuers (as such term is 
defined in section 2791 of the Public Health Service 
Act (42 U.S.C. 300gg–91)) and managed care enti-
ties that enter into contracts with States for the 
purpose of administering such plans; and 
‘‘(3) providers of items and services (including 
accountable care organizations) with respect to items 
and services provided under such plans. 
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‘‘(b) COORDINATION WITH OTHER QUALITY MEAS-
URES.— 
‘‘(1) MEDICAID QUALITY MEASUREMENT PRO-
GRAM.—The maternity care quality measurement 
program under subsection (a) shall be developed, ad-
ministered, and evaluated on an ongoing basis as 
part of, and in coordination with, the Medicaid 
Quality Measurement Program established under 
section 1139B(b)(5)(A) and the pediatric quality 
measures 
program 
established 
under 
section 
1139A(b). In coordination with the publication re-
quirements 
under 
section 
1139A(b)(5) 
and 
1139B(b)(5)(B), the Secretary annually shall pub-
lish recommended changes to the core set of mater-
nity care quality measures published under sub-
section (c) that shall reflect the development, test-
ing, validation, and consensus process described in 
subsection (d). 
‘‘(2) 
IDENTIFICATION
OF
MEASUREMENT 
GAPS.—The maternity care quality measurement 
program under subsection (a) shall include proce-
dures for identifying quality measure gaps and es-
tablishing priorities for the development and ad-
vancement of new or modified quality measures 
under the maternity care quality measurement pro-
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gram, the Medicaid Quality Measurement Program 
established under section 1139B(b)(5)(A) and the 
pediatric quality measures program established 
under section 1139A(b). 
‘‘(3) REPORTS TO CONGRESS AND MACPAC.— 
Not later than January 1, 2017, and every 3 years 
thereafter, the Secretary shall include in the reports 
required 
under 
sections 
1139A(a)(6) 
and 
1139B(b)(4) to Congress and the Medicaid and 
CHIP Payment and Access Commission information 
similar to the information required under such sec-
tions with respect to the measures established under 
this section. 
‘‘(c) IDENTIFICATION OF AN INITIAL SET OF MATER-
NITY CARE QUALITY MEASURES.— 
‘‘(1) CONSULTATION AND PUBLIC COMMENT.— 
Not later than January 1, 2014, the Secretary 
shall— 
‘‘(A) solicit public comment on a rec-
ommended initial core set of maternity care 
quality measures; and 
‘‘(B) consult with stakeholders identified in 
subsection (i)(1) regarding such measures. 
‘‘(2) PUBLICATION.—Not later than January 1, 
2015, the Secretary shall identify, and publish, from 
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maternity care quality measures endorsed under sec-
tion 1890(b)(2), an initial core set of maternity care 
quality measures. 
‘‘(3) STANDARDIZED
REPORTING.—The Sec-
retary shall develop a standardized format for re-
porting information based on the initial core set of 
maternity care quality measure for voluntary use in 
data collection and reporting by— 
‘‘(A) a State in administering a State plan 
under title XIX or a State Child Health Plan 
under title XXI; 
‘‘(B) health insurance issuers and man-
aged care entities that enter into contracts with 
States for the purpose of administering such 
plans; and 
‘‘(C) providers of items and services (in-
cluding accountable care organizations) with re-
spect to items and services provided under such 
plans. 
‘‘(d) DEVELOPMENT
OF
ADDITIONAL
QUALITY 
MEASURES.— 
‘‘(1) CONTRACTS WITH QUALIFIED ENTITIES.— 
Not later than the end of the 6-month period begin-
ning on the date the Secretary publishes the initial 
measures under subsection (c)(2), subject to sub-
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section (b), the Secretary, acting through the Agen-
cy for Healthcare Research and Quality, in consulta-
tion with the Centers for Medicare & Medicaid Serv-
ices, shall enter into grants, contracts, or intergov-
ernmental agreements with qualified measure devel-
opment entities for the purpose of developing, test-
ing, and validating maternity care quality measures 
in areas that are not adequately covered by the 
measures so published. 
‘‘(2) QUALIFIED MEASURE DEVELOPMENT EN-
TITY
DEFINED.—For purposes of this subsection, 
the term ‘qualified measure development entity’ 
means an entity that— 
‘‘(A) has demonstrated expertise and ca-
pacity in the development and testing of quality 
measures; 
‘‘(B) has adopted procedures for quality 
measure development that ensure the inclusion 
of— 
‘‘(i) the views of the individuals and 
entities referred to in subsection (e)(2)(E) 
and whose performance will be assessed by 
the measures; and 
‘‘(ii) the views of other individuals 
and entities (including patients, con-
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(1), in developing quality measures, shall con-
sult with the voluntary consensus standards set-
ting organizations and other organizations in-
volved in the advancement of evidence-based 
measures of health care as the Secretary 
consults with under sections 1139A(b)(3)(H) 
and 1139B(b)(5)(A) to create eMeasures that 
are aligned with the measures developed under 
the Medicaid Quality Measurement Program es-
tablished under section 1139B(b)(5)(A) and the 
pediatric quality measures program established 
under section 1139A(b). 
‘‘(B) eMEASURE DEFINED.—For purposes 
of this section, the term ‘eMeasure’ means a 
measure for which measurement data (including 
clinical data) will be collected electronically, in-
cluding through the use of electronic health 
records and other electronic data sources. 
‘‘(4) 
ENDORSEMENT.—Any 
maternity 
care 
quality measures developed under this subsection by 
a qualified measure development entity shall be sub-
mitted by the qualified measure development entity 
to the consensus-based entity with a contract under 
section 1890(a)(1) to be considered for endorsement 
under section 1890(b)(2). 
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‘‘(e) TYPES OF MEASURES.— 
‘‘(1) IN
GENERAL.—The maternity quality 
measures identified under subsection (c) and the 
measures developed under subsection (d) shall— 
‘‘(A) be evidence-based; 
‘‘(B) utilize risk adjustment or risk strati-
fication methodologies, if appropriate; 
‘‘(C) utilize attribution methods to specify 
the clinicians, facilities, and other entities that 
the measures are applicable to; 
‘‘(D) be pilot-tested with regards to sci-
entific validity, feasibility, and attribution meth-
od; and 
‘‘(E) include a balance of each of the types 
of measures listed in paragraph (2). 
‘‘(2) LIST
OF
TYPES
OF
MEASURES.—The 
measures listed in this paragraph are the following: 
‘‘(A) Measures of the process, experience, 
efficiency, and outcomes of maternity care, in-
cluding postpartum outcomes. 
‘‘(B) Measures that apply to— 
‘‘(i) women and newborns who are 
healthy and at low risk, including meas-
ures 
of 
appropriately 
low-intervention, 
physiologic birth in low-risk women; and 
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‘‘(ii) women and newborns at higher 
risk. 
‘‘(C) Measures that apply to— 
‘‘(i) childbearing women; and 
‘‘(ii) newborns. 
‘‘(D) Measures that apply to care during— 
‘‘(i) pregnancy; 
‘‘(ii) intrapartum period; and 
‘‘(iii) the postpartum period. 
‘‘(E) Measures that apply to— 
‘‘(i) clinicians and clinician groups; 
‘‘(ii) facilities; 
‘‘(iii) health plans; and 
‘‘(iv) accountable care organizations. 
‘‘(F) Measurement of— 
‘‘(i) disparities; 
‘‘(ii) care coordination; and 
‘‘(iii) shared decisionmaking. 
‘‘(3) PHYSIOLOGIC DEFINED.—For purposes of 
this subsection, the term ‘physiologic’ means char-
acteristic of or conforming to the normal functioning 
or state of the body or a tissue or organ, normal, 
and not pathologic. 
‘‘(4) CONSTRUCTION.—Nothing in this sub-
section shall be construed as supporting the restric-
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tion of coverage, under title XIX or XXI or other-
wise, to only those services that are evidence-based, 
or in anyway limiting available services. 
‘‘(f) 
MATERNITY
CONSUMER
ASSESSMENT
OF 
HEALTHCARE PROVIDERS AND SYSTEMS SURVEYS.— 
‘‘(1) ADAPTION OF SURVEYS.—Not later than 
January 1, 2016, for the purpose of measuring the 
care 
experiences 
of 
childbearing 
women 
and 
newborns, the Agency for Healthcare Research and 
Quality shall adapt the Consumer Assessment of 
Healthcare Providers and Systems program surveys 
of— 
‘‘(A) providers; 
‘‘(B) facilities; and 
‘‘(C) health plans. 
‘‘(2) SURVEYS
MUST
BE
EFFECTIVE.—The 
Agency for Healthcare Research and Quality shall 
ensure that the surveys adapted under paragraph 
(1) are effective in measuring aspects of care that 
childbearing women and newborns experience, which 
may include— 
‘‘(A) various types of care settings; 
‘‘(B) various types of caregivers; 
‘‘(C) considerations relating to pain; 
‘‘(D) shared decisionmaking; 
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‘‘(E) supportive care around the time of 
birth; and 
‘‘(F) other topics relevant to the quality of 
the experience of childbearing women and 
newborns. 
‘‘(3) LANGUAGES.—The surveys adapted under 
paragraph (1) shall be available in English and 
Spanish. 
‘‘(4) 
ENDORSEMENT.—The 
Agency 
for 
Healthcare Research and Quality shall submit any 
Consumer Assessment of Healthcare Providers and 
Systems surveys adapted under this subsection to 
the consensus-based entity with a contract under 
section 1890(a)(1) to be considered for endorsement 
under section 1890(b)(2). 
‘‘(5) CONSULTATION.—The adaption of (and 
process for applying) the surveys under paragraph 
(1) shall be conducted in consultation with the 
stakeholders identified in subsection (i)(1). 
‘‘(g) ANNUAL STATE REPORTS REGARDING STATE- 
SPECIFIC QUALITY OF CARE MEASURES APPLIED UNDER 
MEDICAID.— 
‘‘(1) ANNUAL
STATE
REPORTS.—Each State 
with a State plan or waiver approved under title 
XIX shall annually report (separately or as part of 
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an annual report required under section 1139A(c) or 
section 1139B(d)), to the Secretary on the— 
‘‘(A) State-specific maternity health qual-
ity measures applied by the State under the 
such plan; and 
‘‘(B) State-specific information on the 
quality of maternity care furnished to Medicaid 
eligible individuals under such plan, including 
information collected through external quality 
reviews of managed care organizations under 
section 1932 and benchmark plans under sec-
tion 1937. 
‘‘(2) PUBLICATION.—Not later than September 
30, 2015, and annually thereafter, the Secretary 
shall collect, analyze, and make publicly available the 
information reported by States under subparagraph 
(A). 
‘‘(h) CONVERSION OF CURRENTLY ENDORSED MEAS-
URES AND CREATION OF INITIAL QUALITY DATA MODEL 
TO ENABLE ELECTRONIC HEALTH RECORDS TO MEAS-
URE
THE
CARE
OF
CHILDBEARING
WOMEN
AND 
NEWBORNS.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2015, for the purpose of fostering automated pa-
tient-centered longitudinal quality measurement of 
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maternal and newborn care using clinical data, the 
consensus-based entity with a contract under section 
1890(b)(2) shall coordinate— 
‘‘(A) the conversion of endorsed measures 
for the care of childbearing women and 
newborns to eMeasures (as such term is defined 
in subsection (d)(3)(B)); and 
‘‘(B) the development of an initial quality 
data model for use within electronic health 
records of childbearing women and newborns 
enrolled in a program administered by a State 
through State plans under title XIX and State 
Child Health plans under title XXI for pur-
poses of such eMeasures. 
‘‘(2) REQUIREMENTS FOR EMEASURE CONVER-
SION AND QUALITY DATA MODEL CREATION.—The 
conversion to eMeasures and the quality data model 
creation under paragraph (1) shall, for each quality 
measure of the care of childbearing women or 
newborns that the consensus-based entity with a 
contract under section 1890(b)(2) has endorsed, use 
the entity’s measure authoring tool to— 
‘‘(A) specify standard data elements, qual-
ity data elements, and data flow connectors to 
electronic information; 
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‘‘(B) specify quality measure logical state-
ments; 
‘‘(C) test quality measure validity with an 
appropriate electronic health record test data-
base; 
‘‘(D) finalize eMeasures for export to elec-
tronic health record systems; and 
‘‘(E) carry out this work in— 
‘‘(i) collaboration with the developer 
or sponsor of each endorsed measure, who 
is responsible, under an agreement with 
the entity that endorsed such measure, for 
updating such measure; and 
‘‘(ii) consultation with the stake-
holders identified in subsection (i)(1). 
‘‘(3) COORDINATION
WITH
HITECH
ACT.—In 
carrying out activities under this subsection, the 
consensus-based entity with a contract under section 
1890(b)(2) shall take into account, and to the extent 
practicable, coordinate with, similar activities relat-
ing to the implementation of the Health Information 
Technology for Economic and Clinical Health Act 
established under title XIII of division A and title 
IV of division B of Public Law 111–5. 
‘‘(i) STAKEHOLDERS.— 
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‘‘(1) IN GENERAL.—The stakeholders identified 
in this paragraph are— 
‘‘(A) the various clinical disciplines and 
specialties involved in providing maternity care; 
‘‘(B) State Medicaid administrators; 
‘‘(C) maternity care consumers and their 
advocates; 
‘‘(D) technical experts in quality measure-
ment; 
‘‘(E) hospital, facility and health system 
leaders; 
‘‘(F) employers and purchasers; and 
‘‘(G) other individuals who are involved in 
the advancement of evidence-based maternity 
care quality measures. 
‘‘(2) 
PROFESSIONAL
ORGANIZATIONS.—The 
stakeholders identified under paragraph (1) may in-
clude representatives from relevant national medical 
specialty and professional organizations and spe-
cialty societies. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $28,000,000 to carry 
out this section. Funds appropriated under this subsection 
shall remain available until expended.’’. 
(b) CONFORMING AMENDMENTS.— 
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(1) Section 1139A(a)(6) of the Social Security 
Act (42 U.S.C. 1320b–9a(a)(6)) is amended, in the 
matter preceding subparagraph (A), by inserting 
‘‘and the Medicaid and CHIP Payment and Access 
Commission’’ after ‘‘Congress’’. 
(2) Section 1139B(b)(4) of such Act (42 U.S.C. 
1320b–9b(b)(4)) is amended by inserting ‘‘and the 
Medicaid and CHIP Payment and Access Commis-
sion’’ after ‘‘Congress’’. 
SEC. 3. QUALITY COLLABORATIVES. 
(a) GRANTS.—The Secretary of Health and Human 
Services (in this section referred to as the ‘‘Secretary’’) 
may make grants to eligible entities to support— 
(1) the development of new State and regional 
maternity care quality collaboratives; 
(2) expanded activities of existing maternity 
care quality collaboratives; and 
(3) maternity care initiatives within established 
State and regional quality collaboratives that are not 
focused exclusively on maternity care. 
(b) ELIGIBLE ENTITY.—The following entities shall 
be eligible for a grant under subsection (a): 
(1) Quality collaboratives that focus entirely, or 
in part, on maternity care initiatives, to the extent 
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that such collaboratives use such grant only for such 
initiatives. 
(2) Entities seeking to establish a maternity 
care quality collaborative. 
(3) State Medicaid agencies. 
(4) State departments of health. 
(5) Health insurance issuers (as such term is 
defined in section 2791 of the Public Health Service 
Act (42 U.S.C. 300gg–91)). 
(6) Provider organizations, including associa-
tions representing— 
(A) health professionals; and 
(B) hospitals. 
(c) ELIGIBLE PROJECTS AND PROGRAMS.—In order 
for a project or program of an eligible entity to be eligible 
for funding under subsection (a), the project or program 
must have goals that are designed to improve the quality 
of maternity care delivered, such as— 
(1) improving the appropriate use of cesarean 
section; 
(2) reducing maternal and newborn morbidity 
rates; 
(3) improving breast-feeding rates; 
(4) reducing hospital readmission rates; 
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(5) identifying improvement priorities through 
shared peer review and third-party reviews of quali-
tative and quantitative data, and developing and car-
rying out projects or programs to address such pri-
orities; or 
(6) delivering risk-appropriate levels of care. 
(d) ACTIVITIES.—Activities that may be supported by 
the funding under subsection (a) include the following: 
(1) Facilitating performance data collection and 
feedback reports to providers with respect to their 
performance, relative to peers and benchmarks, if 
any. 
(2) Developing, implementing, and evaluating 
protocols and checklists to foster safe, evidence- 
based practice. 
(3) Developing, implementing, and evaluating 
programs that translate into practice clinical rec-
ommendations supported by high-quality evidence in 
national guidelines, systematic reviews, or other well- 
conducted clinical studies. 
(4) Developing underlying infrastructure needed 
to support quality collaborative activities under this 
subsection. 
(5) Providing technical assistance to providers 
and institutions to build quality improvement capac-
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ity and facilitate participation in collaborative activi-
ties. 
(6) Developing the capability to access the fol-
lowing data sources: 
(A) A mother’s prenatal, intrapartum, and 
postpartum records. 
(B) A mother’s medical records. 
(C) An infant’s medical records since birth. 
(D) Birth and death certificates. 
(E) Any other relevant State-level gen-
erated data (such as data from the pregnancy 
risk 
assessment 
management 
system 
(PRAMS)). 
(7) Developing access to blinded liability claims 
data, analyzing the data, and using the results of 
such analysis to improve practice. 
(e) SPECIAL RULE FOR BIRTHS.— 
(1) IN GENERAL.—Subject to paragraph (2), if 
a grant under subsection (a) is for a project or pro-
gram that focuses on births, at least 25 percent of 
the births addressed by such project or program 
must occur in health facilities that perform fewer 
than 1,000 births per year. 
(2) EXCEPTION.—In the case of a grant under 
subsection (a) for a project or program located in a 
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State in which less than 25 percent of the health fa-
cilities in the State perform less than 1,000 births 
per year, the percentage of births in such facilities 
addressed by such project or program shall be com-
mensurate with the Statewide percentage of births 
performed at such facilities. 
(f) USE OF QUALITY MEASURES.—Projects and pro-
grams for which such a grant is made shall— 
(1) include data collection with rapid analysis 
and feedback to participants with a focus on improv-
ing practice and health outcomes; 
(2) develop a plan to identify and resolve data 
collection problems; 
(3) identify and document evidence-based strat-
egies that will be used to improve performance on 
quality measures and other metrics; and 
(4) exclude from quality measure collection and 
reporting physicians and midwives who attend fewer 
than 30 births per year. 
(g) REPORTING ON QUALITY MEASURES.—Any re-
porting requirements established by a project or program 
funded under subsection (a) shall be designed to— 
(1) minimize costs and administrative effort; 
and 
(2) use existing data resources when feasible. 
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(h) CLEARINGHOUSE.—The Secretary shall establish 
an online, open-access clearinghouse to make protocols, 
procedures, reports, tools, and other resources of indi-
vidual collaboratives available to collaboratives and other 
entities that are working to improve maternity care qual-
ity. 
(i) EVALUATION.—A quality collaborative (or other 
entity receiving a grant under subsection (a)) shall— 
(1) develop and carry out plans for evaluating 
its maternity care quality improvement programs 
and projects; and 
(2) publish its experiences and results in arti-
cles, technical reports, or other formats for the ben-
efit of others working on maternity care quality im-
provement activities. 
(j) ANNUAL REPORTS TO SECRETARY.—A quality 
collaborative or other eligible entity that receives a grant 
under subsection (a) shall submit an annual report to the 
Secretary containing the following: 
(1) A description of the activities carried out 
using the funding from such grant. 
(2) A description of any barriers that limited 
the ability of the collaborative or entity to achieve its 
goals. 
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(3) The achievements of the collaborative or en-
tity under the grant with respect to the quality, 
health outcomes, and value of maternity care. 
(4) A list of lessons learned from the grant. 
Such reports shall be made available to the public. 
(k) GOVERNANCE.— 
(1) IN GENERAL.—A maternity care quality col-
laborative or a maternity care program within a 
broader quality collaborative that is supported under 
subsection (a) shall be governed by a multi-stake-
holder executive committee. 
(2) COMPOSITION.—Such executive committee 
shall include individuals who represent— 
(A) physicians, including physicians in the 
fields of general obstetrics, maternal-fetal medi-
cine, family medicine, neonatology, and pediat-
rics; 
(B) nurse-practitioners and nurses; 
(C) certified nurse-midwives and certified 
midwives; 
(D) health facilities and health systems; 
(E) consumers; 
(F) employers and other private pur-
chasers; 
(G) Medicaid programs; and 
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(H) other public health agencies and orga-
nizations, as appropriate. 
Such committee also may include other individuals, 
such as individuals with expertise in health quality 
measurement and other types of expertise as rec-
ommended by the Secretary. Such committee also 
may be composed of a combination of general col-
laborative executive committee members and mater-
nity specific project executive committee members. 
(l) CONSULTATION.—A quality collaborative or other 
eligible entity that receives a grant under subsection (a) 
shall engage in regular ongoing consultation with— 
(1) regional and State public health agencies 
and organizations; 
(2) public and private health insurers; and 
(3) regional and State organizations rep-
resenting physicians, midwives, and nurses who pro-
vide maternity services. 
(m) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $15,000,000 to carry 
out this section. Funds appropriated under this subsection 
shall remain available until expended. 
SEC. 4. WOMAN- AND FAMILY-CENTERED MATERNITY CARE 
HOME DEMONSTRATION PROGRAM. 
(a) DEFINITIONS.—In this section: 
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(1) CHIP.—The term ‘‘CHIP’’ means the 
State Children’s Health Insurance Program estab-
lished under title XXI of the Social Security Act (42 
U.S.C. 1397aa et seq.). 
(2) ELIGIBLE INDIVIDUALS.—The term ‘‘eligi-
ble individual’’ means a childbearing woman who is 
receiving assistance under Medicaid or CHIP. 
(3) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a State, an entity or organization receiv-
ing payments under Medicaid or CHIP, a hospital, 
a freestanding birth center (as defined in section 
1905(l)(3)(B) of the Social Security Act (42 U.S.C. 
1396d(l)(3)(B)), an entity or organization receiving 
assistance under section 330 of the Public Health 
Service Act (42 U.S.C. 254b), a federally qualified 
health center (as defined in subsection (l)(2)(C) of 
section 1905 of the Social Security Act (42 U.S.C. 
1396d), a rural health clinic (as defined in sub-
section (l)(1) of such section), or an entity that re-
ceives assistance under title X or XX of the Public 
Health Service Act (42 U.S.C. 300 et seq., 300z et 
seq.), that submits an approved application to the 
Secretary to conduct a demonstration project under 
this section. 
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(4) MEDICAID.—The term ‘‘Medicaid’’ means 
the Federal and State program for medical assist-
ance established under title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.). 
(5) PRINCIPAL MATERNITY CARE PROVIDER.— 
The term ‘‘principal maternity care provider’’ 
means: 
(A) A physician (as defined in section 
1861(r)(1) of the Social Security Act (42 
U.S.C. 1395x(r)(1)) who meets the following re-
quirements: 
(i) The physician is a board certified 
physician who specializes in women’s 
health issues, such as obstetrics and gyne-
cology, or family practice, and who pro-
vides continuous and comprehensive care 
for individuals under the physician’s care. 
(ii) The physician has the staff and 
resources to manage the comprehensive 
and coordinated health care of each such 
individual. 
(iii) The physician practices in a prac-
tice, health or birth center, clinic, or hos-
pital recognized to be a maternity care 
home. 
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fective 
prenatal, 
intrapartum, 
and 
postpartum services and practices. 
(ix) Plan for childbirth that supports 
utilization of evidence-based intrapartum 
practices. 
(x) Care of the newborn from birth 
until transition to the baby’s primary care 
provider, including preventive practices 
promoting optimal feeding and attachment. 
(xi) Postpartum health services for 
the first two months after birth, including 
family planning, weight control, exercise, 
nutrition, and other preventive services; as-
sessment and treatment for postpartum 
depression and other mood disorders; as-
sessment and treatment of other new-onset 
conditions that may include infection, pain, 
and heavy bleeding; and any continuing 
needs for help with smoking cessation, sub-
stance abuse, and other health risks. 
(xii) At the conclusion of maternity 
services and as needed in the course of ma-
ternity services, communication with the 
primary care providers of the woman and 
newborn about care processes, outcomes of 
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maternal and newborn care, and any con-
tinuing health care needs. 
(xiii) Any other services specified by 
the Secretary. 
(B) The practice, health or birth center, 
clinic, or hospital applies standards for access 
to care and communication with eligible individ-
uals participating in the demonstration program 
established under this section, including direct 
and ongoing access to the principal maternity 
care provider who accepts responsibility for pro-
viding continuous care, including coordination 
for comprehensive maternity care to the whole 
person, in collaboration with a team of other 
health professionals, including other nurses, pri-
mary care and specialist physicians, and mental 
health professionals, as needed and appropriate. 
Care is patient and family centered, culturally 
and linguistically appropriate, structured to en-
sure women receive complete and accurate 
health information for shared decisionmaking, 
and structured to assure confidentiality so that 
teens and women may seek needed care in a 
timely way. 
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(C) The practice, health or birth center, 
clinic, or hospital has readily accessible, clini-
cally useful records on eligible individuals par-
ticipating in the demonstration program estab-
lished under this section, when feasible through 
electronic health records available in ambula-
tory and inpatient settings, that enable the 
practice to treat such individuals comprehen-
sively and systematically. 
(D) The practice, health or birth center, 
clinic or hospital maintains continuous relation-
ships with eligible individuals participating in 
the demonstration program established under 
this section by implementing clinical rec-
ommendations supported by high-quality evi-
dence in national guidelines, systematic reviews, 
or other well-conducted clinical studies and ap-
plying them to the identified needs of such indi-
viduals over time and with the intensity needed 
by such individuals. 
(E) The practice, health or birth center, 
clinic, or hospital supports eligible individuals in 
self-care to pursue their goals and achieve opti-
mal health. 
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(F) The practice, health or birth center, 
clinic, or hospital assesses and addresses bar-
riers to communication between health profes-
sions and eligible individuals. 
(G) The practice, health or birth center, 
clinic, or hospital has in place the resources and 
processes necessary to achieve improvements in 
the management and coordination of care for 
eligible individuals participating in the dem-
onstration program established under this sec-
tion, including— 
(i) providing training programs for 
personnel involved in the coordination of 
care; 
(ii) utilizing information technology to 
support optimal patient care, performance 
measurement and use of the results to im-
prove practice, patient education, and en-
hanced communication; and 
(iii) implementation of programs to 
improve the quality of care. 
(H) The practice, health or birth center, 
clinic, or hospital meets the requirements im-
posed on a covered entity for purposes of apply-
ing part C of title XI of the Public Health 
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Service Act (42 U.S.C. 300b–1 et seq.) and all 
regulatory provisions promulgated there under, 
including regulations (relating to privacy) 
adopted pursuant to the authority of the Sec-
retary under section 264(c) of the Health In-
surance Portability and Accountability Act of 
1996 (42 U.S.C. 1320d–2 note). 
(b) ESTABLISHMENT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, the Secretary 
shall establish a maternity care home demonstration 
program (in this section referred to as the ‘‘pro-
gram’’). 
(2) DURATION; SCOPE.—The program shall be 
conducted for a 3-year period (except that an eligible 
individual participating in the program shall remain 
eligible for items and services provided under the 
program through 2 months postpartum regardless of 
the termination of the program period) and shall in-
clude a nationally representative sample of physi-
cians, advanced practice nurses, certified nurse mid-
wives, certified midwives, and physician assistants 
who specialize in women’s health issues, such as ob-
stetrics and gynecology, or family practice, and who 
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serve urban, rural, and underserved areas in a total 
of no more than 8 States. 
(3) 
COMPREHENSIVENESS.—The 
Secretary 
shall give priority under the program to demonstra-
tion projects that reflect a comprehensive inclusion 
of the care components identified under subsection 
(a)(7)(A). 
(4) ENCOURAGING
PARTICIPATION
OF
SMALL 
PHYSICIAN PRACTICES.—The program shall be de-
signed to include the participation of maternity care 
providers in practices with fewer than 4 full-time 
equivalent clinicians, as well as maternity care pro-
viders in larger practices, particularly in rural and 
underserved areas. 
(5) PROGRAM GOALS.—The program shall be 
designed in order to determine whether and to what 
extent maternity care homes accomplish the fol-
lowing: 
(A) Increase— 
(i) cost efficiencies of maternity care 
delivery; 
(ii) the reliable provision of care sup-
ported by high-quality evidence in national 
guidelines, systematic reviews, or other 
well-conducted clinical studies; 
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(II) increased vaginal birth and 
initiation and duration of exclusive 
breast feeding. 
(6) ELIGIBLE INDIVIDUAL AND ELIGIBLE ENTI-
TY PARTICIPATION.— 
(A) ELIGIBLE
INDIVIDUALS.—The Sec-
retary shall establish a process under which— 
(i) an eligible individual may elect to 
participate in a maternity care home under 
the program; and 
(ii) no cost sharing shall be imposed 
with respect to any service required under 
to be provided to the individual under the 
program. 
(B) ASSURANCE OF PARTICIPATION OF EL-
IGIBLE
ENTITIES
THAT
ARE
NOT
PARTICI-
PATING PROVIDERS OR ARE IN STATES WITH 
MANAGED CARE.—The Secretary shall establish 
a process to ensure that eligible entities that 
are not participating providers under Medicaid 
or CHIP in the State, or, in the case of a State 
that contracts with a private entity to manage 
parts of the Medicaid or CHIP in the State, do 
not participate with that entity, are able to par-
ticipate in the program. 
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(7) STANDARD
SETTING
PROCESS.—In con-
sultation with the stakeholders specified in sub-
section (d), the Secretary shall— 
(A) develop a maternity care home reim-
bursement methodology that takes into consid-
eration, to the maximum extent practicable— 
(i) recognition of the value of mater-
nity care provider and clinical staff work 
associated with patient care that falls out-
side the face-to-face visit, such as the time 
and effort spent on educating family mem-
bers and arranging appropriate followup 
services with other health care profes-
sionals; 
(ii) reimbursement of services associ-
ated with coordination of care both within 
a given practice and between consultants, 
ancillary providers, and community re-
sources; 
(iii) recognition of expenses that the 
maternity care home practices will incur to 
acquire and utilize health information tech-
nology, such as clinical decision support 
tools, patient registries, or electronic med-
ical records; 
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(iv) reimbursement for separately 
identifiable e-mail and telephonic consulta-
tions, either as separately billable services 
or as part of a global management fee; 
(v) recognition of the value of provider 
work associated with remote monitoring of 
clinical data using technology; 
(vi) reimbursement for provision of 
preventive services, health education, and 
participation in shared decisionmaking; 
(vii) recognition and sharing of sav-
ings with respect to reduction of proce-
dures and practices that are contrary to 
high-quality evidence in national guide-
lines, systematic reviews, or other well-con-
ducted clinical studies and to reductions in 
the occurrence of health and pregnancy 
complications, hospitalization rates, med-
ical errors, adverse drug reactions, and 
other occurrences; 
(viii) allowance for additional pay-
ments for achieving measurable and con-
tinuous quality improvements, including 
under a process established by the Sec-
retary for paying a performance-based 
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bonus to maternity care homes which meet 
or achieve substantial improvements in 
performance (as specified under clinical, 
patient experience of care, and efficiency 
benchmarks established by the Secretary); 
(ix) recognition of the existing pay-
ment methodology for federally qualified 
health centers when determining the most 
appropriate 
mechanism 
for 
providing 
bonus payments for maternity care home 
services delivered at such centers; and 
(x) such other innovative methods as 
the Secretary finds appropriate; 
(B) develop appropriate risk-adjustment 
mechanisms to account for varying costs of ma-
ternity care homes based upon characteristics of 
the eligible individuals participating in the pro-
gram; 
(C) make allowance for additional pay-
ments for achieving measurable and continuous 
quality improvements, including under a process 
established by the Secretary for paying a per-
formance-based bonus to maternity care homes 
which meet or achieve substantial improvements 
in performance (as specified under clinical, pa-
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tient experience, and efficiency benchmarks es-
tablished by the Secretary in consultation with 
the stakeholders specified in subsection (d)); 
(D) recognize the existing payment meth-
odology for federally qualified health centers 
when determining the most appropriate mecha-
nism for providing bonus payments for mater-
nity care home services delivered at such cen-
ters; and 
(E) establish such other methods as the 
Secretary, in consultation with the stakeholders 
specified in subsection (d), finds appropriate. 
(8) PLANNING OR IMPLEMENTATION GRANTS.— 
The Secretary may award planning or implementa-
tion grants to eligible entities desiring or selected to 
participate in the program. 
(9) ONGOING OVERSIGHT AND PERFORMANCE 
ASSESSMENT.—The Secretary shall establish proce-
dures to ensure that hospitals, practices, health or 
birth centers, and clinics participating as maternity 
care homes under the program, and the physicians, 
advanced practice nurses, certified nurse-midwives, 
certified midwives, and physician assistants pro-
viding services at such hospitals, practices, centers, 
and clinics, have access to confidential feedback and 
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