I 
117TH CONGRESS 
1ST SESSION 
H. R. 950 
To require the Secretary of Health and Human Services to establish and 
implement a Perinatal Care Alternative Payment Model Demonstration 
Project, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 8, 2021 
Ms. SCHAKOWSKY (for herself, Ms. UNDERWOOD, Ms. ADAMS, Mr. KHANNA, 
Ms. VELA´ZQUEZ, Mrs. MCBATH, Mr. SMITH of Washington, Ms. SCAN-
LON, Mr. LAWSON of Florida, Mrs. HAYES, Mr. BUTTERFIELD, Ms. 
MOORE of Wisconsin, Ms. STRICKLAND, Mr. RYAN, Mr. SCHIFF, Mr. 
JOHNSON of Georgia, Mr. HORSFORD, Ms. WASSERMAN SCHULTZ, Ms. 
BARRAGA´N, Mr. DEUTCH, Mr. PAYNE, Mr. BLUMENAUER, Mr. 
MOULTON, Mr. SOTO, Mr. NADLER, Mr. TRONE, Ms. CLARKE of New 
York, Ms. BASS, Ms. PRESSLEY, Mr. EVANS, Ms. BLUNT ROCHESTER, 
Ms. CASTOR of Florida, Ms. SEWELL, and Ms. WILLIAMS of Georgia) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To require the Secretary of Health and Human Services 
to establish and implement a Perinatal Care Alternative 
Payment Model Demonstration Project, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Innovative Maternal 
Payment And Coverage To Save Moms Act’’ or the ‘‘IM-
PACT to Save Moms Act’’. 
SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL 
DEMONSTRATION PROJECT. 
(a) IN GENERAL.—For the period of fiscal years 
2022 through 2026, the Secretary of Health and Human 
Services (referred to in this section as the ‘‘Secretary’’), 
acting through the Administrator of the Centers for Medi-
care & Medicaid Services, shall establish and implement, 
in accordance with the requirements of this section, a 
demonstration project, to be known as the Perinatal Care 
Alternative Payment Model Demonstration Project (re-
ferred to in this section as the ‘‘Demonstration Project’’), 
for purposes of allowing States to test payment models 
under their State plans under title XIX of the Social Secu-
rity Act (42 U.S.C. 1396 et seq.) and State child health 
plans under title XXI of such Act (42 U.S.C. 1397aa et 
seq.) with respect to maternity care provided to pregnant 
and postpartum individuals enrolled in such State plans 
and State child health plans. 
(b) COORDINATION.—In establishing the Demonstra-
tion Project, the Secretary shall coordinate with stake-
holders such as— 
(1) State Medicaid programs; 
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(2) relevant organizations representing mater-
nal health care providers; 
(3) relevant organizations representing patients, 
with a particular focus on individuals from demo-
graphic groups with disproportionate rates of ad-
verse maternal health outcomes; 
(4) relevant community-based organizations, 
particularly organizations that seek to improve ma-
ternal health outcomes for individuals from demo-
graphic groups with disproportionate rates of ad-
verse maternal health outcomes; 
(5) non-clinical perinatal health workers such as 
doulas, community health workers, peer supporters, 
certified lactation consultants, nutritionists and di-
eticians, social workers, home visitors, and naviga-
tors; 
(6) relevant health insurance issuers; 
(7) hospitals, health systems, freestanding birth 
centers (as such term is defined in paragraph (3)(B) 
of section 1905(l) of the Social Security Act (42 
U.S.C. 1396d(l))), Federally-qualified health centers 
(as such term is defined in paragraph (2)(B) of such 
section), and rural health clinics (as such term is de-
fined in section 1861(aa) of such Act (42 U.S.C. 
1395x(aa))); 
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(8) researchers and policy experts in fields re-
lated to maternity care payment models; and 
(9) any other stakeholders as the Secretary de-
termines appropriate, with a particular focus on 
stakeholders from demographic groups with dis-
proportionate rates of adverse maternal health out-
comes. 
(c) CONSIDERATIONS.—In establishing the Dem-
onstration Project, the Secretary shall consider each of the 
following: 
(1) Findings from any evaluations of the 
Strong Start for Mothers and Newborns initiative 
carried out by the Centers for Medicare & Medicaid 
Services, the Health Resources and Services Admin-
istration, and the Administration on Children and 
Families. 
(2) Any alternative payment model that— 
(A) is designed to improve maternal health 
outcomes for racial and ethnic groups with dis-
proportionate rates of adverse maternal health 
outcomes; 
(B) includes methods for stratifying pa-
tients by pregnancy risk level and, as appro-
priate, adjusting payments under such model to 
take into account pregnancy risk level; 
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(C) 
establishes 
evidence-based 
quality 
metrics for such payments; 
(D) includes consideration of non-hospital 
birth settings such as freestanding birth centers 
(as so defined); 
(E) includes consideration of social deter-
minants of health that are relevant to maternal 
health outcomes such as housing, transpor-
tation, nutrition, and other non-clinical factors 
that influence maternal health outcomes; or 
(F) includes diverse maternity care teams 
that include— 
(i) maternity care providers, including 
obstetrician-gynecologists, 
family 
physi-
cians, physician assistants, midwives who 
meet, at a minimum, the international def-
inition of the term ‘‘midwife’’ and global 
standards for midwifery education (as es-
tablished by the International Confed-
eration of Midwives), and nurse practi-
tioners— 
(I) from racially, ethnically, and 
professionally diverse backgrounds; 
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(II) with experience practicing in 
racially and ethnically diverse commu-
nities; or 
(III) who have undergone train-
ings on racism, implicit bias, and ex-
plicit bias; and 
(ii) non-clinical perinatal health work-
ers such as doulas, community health 
workers, peer supporters, certified lacta-
tion consultants, nutritionists and dieti-
cians, social workers, home visitors, and 
navigators. 
(d) ELIGIBILITY.—To be eligible to participate in the 
Demonstration Project, a State shall submit an applica-
tion to the Secretary at such time, in such manner, and 
containing such information as the Secretary may require. 
(e) EVALUATION.—The Secretary shall conduct an 
evaluation of the Demonstration Project to determine the 
impact of the Demonstration Project on— 
(1) maternal health outcomes, with data strati-
fied by race, ethnicity, socioeconomic indicators, and 
any other factors as the Secretary determines appro-
priate; 
(2) spending on maternity care by States par-
ticipating in the Demonstration Project; 
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(3) to the extent practicable, subjective meas-
ures of patient experience; and 
(4) any other areas of assessment that the Sec-
retary determines relevant. 
(f) REPORT.—Not later than one year after the com-
pletion or termination date of the Demonstration Project, 
the Secretary shall submit to the Committee on Energy 
and Commerce, the Committee on Ways and Means, and 
the Committee on Education and Labor of the House of 
Representatives and the Committee on Finance and the 
Committee on Health, Education, Labor, and Pensions of 
the Senate, and make publicly available, a report con-
taining— 
(1) the results of any evaluation conducted 
under subsection (e); and 
(2) a recommendation regarding whether the 
Demonstration Project should be continued after fis-
cal year 2026 and expanded on a national basis. 
(g) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section. 
(h) DEFINITIONS.—In this section: 
(1) 
ALTERNATIVE
PAYMENT
MODEL.—The 
term ‘‘alternative payment model’’ has the meaning 
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given such term in section 1833(z)(3)(C) of the So-
cial Security Act (42 U.S.C. 1395l(z)(3)(C)). 
(2) PERINATAL.—The term ‘‘perinatal’’ means 
the period beginning on the day a woman becomes 
pregnant and ending on the last day of the 1-year 
period beginning on the last day of such woman’s 
pregnancy. 
SEC. 3. MACPAC REPORT. 
(a) IN GENERAL.—Not later than two years after the 
date of the enactment of this Act, the Medicaid and CHIP 
Payment and Access Commission shall publish a report 
on issues relating to the continuity of coverage under 
State plans under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) and State child health plans under 
title XXI of such Act (42 U.S.C. 1397aa et seq.) for preg-
nant and postpartum individuals. Such report shall, at a 
minimum, include the following: 
(1) An assessment of any existing policies 
under such State plans and such State child health 
plans regarding presumptive eligibility for pregnant 
individuals while their application for enrollment in 
such a State plan or such a State child health plan 
is being processed. 
(2) An assessment of any existing policies 
under such State plans and such State child health 
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plans regarding measures to ensure continuity of 
coverage under such a State plan or such a State 
child health plan for pregnant and postpartum indi-
viduals, including such individuals who need to 
change their health insurance coverage during their 
pregnancy or the postpartum period following their 
pregnancy. 
(3) An assessment of any existing policies 
under such State plans and such State child health 
plans regarding measures to automatically reenroll 
individuals who are eligible to enroll under such a 
State plan or such a State child health plan as a 
parent. 
(4) If determined appropriate by the Commis-
sion, any recommendations for the Department of 
Health and Human Services, or such State plans 
and such State child health plans, to ensure con-
tinuity of coverage under such a State plan or such 
a State child health plan for pregnant and 
postpartum women. 
(b) POSTPARTUM DEFINED.—In this section, the 
term ‘‘postpartum’’ means the 1-year period beginning on 
the last day of a woman’s pregnancy. 
Æ 
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