I 
117TH CONGRESS 
2D SESSION 
H. R. 8181 
To direct the Secretary of Health and Human Services to issue guidance 
on coverage under the Medicaid program under title XIX of the Social 
Security Act of certain pelvic health services furnished during the 
postpartum period, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 22, 2022 
Ms. HERRERA BEUTLER (for herself and Ms. BLUNT ROCHESTER) introduced 
the following bill; which was referred to the Committee on Energy and 
Commerce 
A BILL 
To direct the Secretary of Health and Human Services to 
issue guidance on coverage under the Medicaid program 
under title XIX of the Social Security Act of certain 
pelvic health services furnished during the postpartum 
period, 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 ‘‘Optimizing 
Postpartum Outcomes Act of 2022’’. 
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SEC. 2. CMS GUIDANCE. 
(a) IN GENERAL.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services shall issue guidance on coverage 
under State plans (or waivers of such plans) under the 
Medicaid program under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) or State child health plans 
(or waivers of such plans) under the Children’s Health In-
surance Program under title XXI of such Act (42 U.S.C. 
1397aa et seq.) of covered pelvic health services furnished 
during the prenatal or postpartum period. Such guidance 
shall include— 
(1) best practices from States with respect to 
innovative or evidenced-based payment models to in-
crease access to covered pelvic health services; 
(2) recommendations for States on available fi-
nancing options under— 
(A) the Medicaid program under title XIX 
of such Act (42 U.S.C. 1396 et seq.); and 
(B) the Children’s Health Insurance Pro-
gram under title XXI of such Act (42 U.S.C. 
1397aa et seq.), specifically funds made avail-
able through a Children’s Health Insurance 
Program Health Services Initiative; 
(3) guidance and technical assistance to State 
agencies responsible for administering State plans 
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(or waivers of such plans) under the Medicaid pro-
gram under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) regarding additional flexibilities 
and incentives related to screening and referral for, 
and access to, covered pelvic health services; and 
(4) guidance regarding suggested terminology 
and diagnosis codes, such as the International Clas-
sification of Diseases code set, to identify women 
with pelvic floor dysfunction and disorders. 
(b) GAO STUDY.—Not later than 1 year after the 
date of the enactment of this Act, the Comptroller General 
of the United States shall conduct a study on, and submit 
to Congress a report that addresses, gaps in coverage 
for— 
(1) covered pelvic health services under State 
plans (or waivers of such plans) under the Medicaid 
program under title XIX of the Social Security Act 
(42 U.S.C. 1396 et seq.) for postpartum women; 
and 
(2) other services for postpartum women who 
received medical assistance under a State plan (or a 
waiver of such plan) under the Medicaid program 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) during their pregnancy. 
(c) DEFINITIONS.—In this section: 
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(1) The term ‘‘postpartum period’’ means the 
longer of the period of lactation or the 6-month pe-
riod beginning on the last day of a woman’s preg-
nancy. 
(2) The term ‘‘covered pelvic health services’’ 
means— 
(A) pelvic floor examinations (as defined in 
section 317L–2 of the Public Health Service 
Act, as added by section 2 of this Act); and 
(B) pelvic health physical therapy (as de-
fined in such section 317L–2). 
SEC. 3. POSTPARTUM PELVIC HEALTH EDUCATION CAM-
PAIGN. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317L–1 (42 U.S.C. 247b–13a) the following: 
‘‘SEC. 317L–2. POSTPARTUM PELVIC HEALTH EDUCATION 
CAMPAIGN. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, in collaboration with the Administrator of the 
Health Resources and Services Administration and the 
heads of other agencies, and in consultation with appro-
priate health professional associations, shall develop and 
carry out a program— 
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‘‘(1) to educate and train health professionals 
on pelvic floor examinations and the benefits of pel-
vic health physical therapy; and 
‘‘(2) to educate postpartum women on— 
‘‘(A) with respect to pelvic floor examina-
tions— 
‘‘(i) the importance of such examina-
tions during the postpartum period; 
‘‘(ii) how to obtain such an examina-
tion, including information relating to ob-
taining referrals; and 
‘‘(iii) what is involved in such an ex-
amination; and 
‘‘(B) with respect to pelvic health physical 
therapy— 
‘‘(i) the benefits of, and availability of 
such physical therapy; and 
‘‘(ii) how to obtain a referral for such 
physical therapy. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) The term ‘pelvic floor examination’ means 
an examination to assess a patient for pelvic health 
related conditions that is composed of— 
‘‘(A) an external evaluation that includes 
analysis of posture, joint integrity, muscle per-
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formance, quality of movement, and palpation 
and observation of the pelvic floor; and 
‘‘(B) if deemed necessary based on the 
health care professional’s clinical reasoning, an 
internal vaginal or rectal examination, or both, 
to gather relevant information about the tone, 
strength, control, ability to contract and relax 
the muscles of the pelvic floor individually and 
together, the condition of the surrounding fas-
cia, and the position of the organs. 
‘‘(2) The term ‘pelvic health physical therapy’ 
means a personalized physical therapy plan imple-
mented by a pelvic health physical therapist, after 
performing a pelvic floor examination and making a 
diagnosis, that is based on best available evidence to 
improve the patient condition, with respect to the 
anatomy of the pelvic floor, improve mobility, re-
cover from injury, prevent future injury, and man-
age pain and chronic conditions. 
‘‘(3) The term ‘pelvic health related condition’ 
includes urinary dysfunction, bowel dysfunction, 
musculoskeletal dysfunction, sexual dysfunction, can-
cer-related rehabilitation, and the pre-partum state 
and pre-partum conditions. 
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