2 additional Prevention Research Centers under the Pre-
vention Research Center Program administered by the 
Centers for Disease Control and Prevention. Such addi-
tional centers shall each be known as a Center for Excel-
lence on Optimal Maternity Outcomes. 
(b) RESEARCH.—Each Center for Excellence on Opti-
mal Maternity Outcomes shall— 
(1) conduct at least one focused program of re-
search to improve maternity outcomes, including the 
reduction of cesarean birth rates, elective inductions, 
prematurity rates, and low birth weight rates within 
an underserved population that has a disproportion-
ately large burden of suboptimal maternity out-
comes, including maternal mortality and morbidity, 
infant mortality, prematurity, or low birth weight; 
(2) work with partners on special interest 
projects, as specified by the Centers for Disease 
Control and Prevention and other relevant agencies 
within the Department of Health and Human Serv-
ices, and on projects funded by other sources; and 
(3) involve a minimum of two distinct birth set-
ting models, such as a hospital labor and delivery 
model and freestanding birth center model; or a hos-
pital labor and delivery model and planned home 
birth model. 
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(c) INTERDISCIPLINARY PROVIDERS.—Each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude the following interdisciplinary providers of maternity 
care: 
(1) Obstetrician-gynecologists. 
(2) Certified nurse midwives or certified mid-
wives. 
(3) At least two of the following providers: 
(A) Family practice physicians. 
(B) Nurse practitioners. 
(C) Physician assistants. 
(D) Certified professional midwives. 
(d) SERVICES.—Research conducted by each Center 
for Excellence on Optimal Maternity Outcomes shall in-
clude at least 2 (and preferably more) of the following sup-
portive provider services: 
(1) Mental health. 
(2) Doula labor support. 
(3) Nutrition education. 
(4) Childbirth education. 
(5) Social work. 
(6) Physical therapy or occupation therapy. 
(7) Substance abuse services. 
(8) Home visiting. 
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(e) COORDINATION.—The programs of research at 
each of the two Centers of Excellence on Optimal Mater-
nity Outcomes shall compliment and not replicate the 
work of the other. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for each of the fiscal years 2014 through 
2018. 
SEC. 203. EXPANDING MODELS TO BE TESTED BY CENTER 
FOR MEDICARE AND MEDICAID INNOVATION 
TO INCLUDE MATERNITY CARE MODELS. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxi) Promoting evidence-based mod-
els of prenatal care that have been associ-
ated with reductions in maternal and in-
fant health disparities; incorporating the 
use of doula and promotoras support; and 
advancing out-of-hospital births, including 
births at home and in freestanding birth 
centers.’’. 
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TITLE III—ENHANCEMENT OF A 
GEOGRAPHICALLY, 
RA-
CIALLY, AND ETHNICALLY DI-
VERSE INTERPROFESSIONAL 
MATERNITY WORKFORCE 
SEC. 301. DEVELOPMENT OF INTERPROFESSIONAL MATER-
NITY 
CARE 
EDUCATIONAL 
MODELS 
AND 
TOOLS. 
(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this Act, the Secretary of Health 
and Human Services, acting in conjunction with the Ad-
ministrator of Health Resources and Services Administra-
tion, shall convene, for a 1-year period, an Interprofes-
sional Maternity Provider Education Commission to dis-
cuss and make recommendations for— 
(1) a consensus standard physiologic maternity 
care curriculum that takes into account the core 
competencies for basic midwifery practice such as 
those developed by the American College of Nurse 
Midwives and the North American Registry of Mid-
wives, and the educational objectives for physicians 
practicing in obstetrics and gynecology as deter-
mined by the Council on Resident Education in Ob-
stetrics and Gynecology; 
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(2) suggestions for multi-disciplinary use of the 
consensus physiologic curriculum; 
(3) strategies to integrate and coordinate edu-
cation across maternity care disciplines, including 
recommendations to increase medical and midwifery 
student exposure to out-of-hospital birth; and 
(4) pilot demonstrations of interprofessional 
educational models. 
(b) PARTICIPANTS.—The Commission shall include 
maternity care educators, curriculum developers, service 
leaders, certification leaders, and accreditation leaders 
from the various professions that provide maternity care 
in this country. Such professions shall include obstetri-
cian-gynecologists, certified nurse midwives or certified 
midwives, family practice physicians, nurse practitioners, 
physician assistants, certified professional midwives, and 
perinatal nurses. Additionally, the Commission shall in-
clude representation from maternity care consumer advo-
cates. 
(c) CURRICULUM.—The consensus standard physio-
logic maternity care curriculum described in subsection 
(a)(1) shall— 
(1) have a public health focus with a foundation 
in health promotion and disease prevention; 
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(2) foster physiologic childbearing and woman 
and family centered care; 
(3) integrate strategies to reduce maternal and 
infant morbidity and mortality; 
(4) incorporate recommendations to ensure re-
spectful, safe, and seamless consultation, referral, 
transport, and transfer of care when necessary; and 
(5) include cultural sensitivity and strategies to 
decrease disparities in maternity outcomes. 
(d) REPORT.—Not later than 6 months after the final 
day of the summit, the Secretary of Health and Human 
Services shall— 
(1) submit to Congress a report containing the 
recommendations made by the summit under this 
section; and 
(2) make such report publicly available. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$1,000,000 for each of the fiscal years 2014 and 2015, 
and such sums as are necessary for each of the fiscal years 
2016 through 2018. 
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SEC. 302. INTERPROFESSIONAL TRAINING OF MEDICAL 
STUDENTS, RESIDENTS, AND STUDENT MID-
WIVES IN ACADEMIC HEALTH CENTERS AND 
FREESTANDING BIRTH CENTERS. 
(a) INCLUDING WITHIN INPATIENT HOSPITAL SERV-
ICES UNDER MEDICARE SERVICES FURNISHED BY CER-
TAIN STUDENTS, INTERNS, AND RESIDENTS SUPERVISED 
BY CERTIFIED NURSE MIDWIVES.—Section 1861(b) of 
the Social Security Act (42 U.S.C. 1395x(b)) is amend-
ed— 
(1) in paragraph (6), by striking ‘‘; or’’ and in-
serting ‘‘, or in the case of services in a hospital or 
osteopathic hospital by a student midwife or an in-
tern or resident-in-training under a teaching pro-
gram previously described in this paragraph who is 
in the field of obstetrics and gynecology, if such stu-
dent midwife, intern, or resident-in-training is super-
vised by a certified nurse-midwife to the extent per-
mitted under applicable State law and as may be au-
thorized by the hospital;’’; 
(2) in paragraph (7), by striking the period at 
the end and inserting ‘‘; or’’; and 
(3) by adding at the end the following new 
paragraph: 
‘‘(8) a certified nurse-midwife where the hos-
pital has a teaching program approved as specified 
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in paragraph (6), if (A) the hospital elects to receive 
any payment due under this title for reasonable 
costs of such services, and (B) all certified nurse- 
midwives in such hospital agree not to bill charges 
for professional services rendered in such hospital to 
individuals covered under the insurance program es-
tablished by this title.’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to services furnished on or after 
the date of the enactment of this Act. 
SEC. 303. GRANTS TO PROFESSIONAL ORGANIZATIONS TO 
INCREASE DIVERSITY IN MATERNITY CARE 
PROFESSIONALS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, through the Administrator of the Health 
Resources and Services Administration, shall carry out a 
grant program under which the Secretary may make to 
eligible health professional organizations— 
(1) for fiscal year 2014, planning grants de-
scribed in subsection (b); and 
(2) for the subsequent 4-year period, implemen-
tation grants described in subsection (c). 
(b) PLANNING GRANTS.— 
(1) IN GENERAL.—Planning grants described in 
this subsection are grants for the following purposes: 
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(A) To collect data and identify any work-
force disparities, with respect to a health pro-
fession, at each of the following areas along the 
health professional continuum: 
(i) Pipeline availability with respect to 
students at the high school and college or 
university levels considering and working 
toward entrance in the profession. 
(ii) Entrance into the training pro-
gram for the profession. 
(iii) Graduation from such training 
program. 
(iv) Entrance into practice. 
(v) Retention in practice for more 
than a 5-year period. 
(B) To develop one or more strategies to 
address the workforce disparities within the 
health profession, as identified under (and in 
response to the findings pursuant to) subpara-
graph (A). 
(2) APPLICATION.—To be eligible to receive a 
grant under this subsection, an eligible health pro-
fessional organization shall submit to the Secretary 
of Health and Human Services an application in 
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such form and manner and containing such informa-
tion as specified by the Secretary. 
(3) AMOUNT.—Each grant awarded under this 
subsection shall be for an amount not to exceed 
$300,000. 
(4) REPORT.—Each recipient of a grant under 
this subsection shall submit to the Secretary of 
Health and Human Services a report containing— 
(A) information on the extent and distribu-
tion of workforce disparities identified through 
the grant; and 
(B) reasonable objectives and strategies 
developed to address such disparities within a 
5-, 10-, and 25-year period. 
(c) IMPLEMENTATION GRANTS.— 
(1) IN GENERAL.—Implementation grants de-
scribed in this subsection are grants to implement 
one or more of the strategies developed pursuant to 
a planning grant awarded under subsection (b). 
(2) APPLICATION.—To be eligible to receive a 
grant under this subsection, an eligible health pro-
fessional organization shall submit to the Secretary 
of Health and Human Services an application in 
such form and manner as specified by the Secretary. 
Each such application shall contain information on 
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the capability of the organization to carry out a 
strategy described in paragraph (1), involvement of 
partners or coalitions, plans for developing sustain-
ability of the efforts after the culmination of the 
grant cycle, and any other information specified by 
the Secretary. 
(3) AMOUNT.—Each grant awarded under this 
subsection shall be for an amount not to exceed 
$500,000 each year during the 4-year period of the 
grant. 
(4) REPORTS.—For each of the first 3 years for 
which an eligible health professional organization is 
awarded a grant under this subsection, the organiza-
tion shall submit to the Secretary of Health and 
Human Services a report on the activities carried 
out by such organization through the grant during 
such year and objectives for the subsequent year. 
For the fourth year for which an eligible health pro-
fessional organization is awarded a grant under this 
subsection, the organization shall submit to the Sec-
retary a report that includes an analysis of all the 
activities carried out by the organization through the 
grant and a detailed plan for continuation of out-
reach efforts. 
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(d) ELIGIBLE HEALTH PROFESSIONAL ORGANIZA-
TION DEFINED.—For purposes of this section, the term 
‘‘eligible health professional organization’’ means a profes-
sional 
organization 
representing 
obstetrician-gyne-
cologists, certified nurse midwives, certified midwives, 
family practice physicians, nurse practitioners whose scope 
of practice includes maternity care, physician assistants 
whose scope of practice includes obstetrical care, or cer-
tified professional midwives. 
(e) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section 
$2,000,000 for fiscal year 2014 and $3,000,000 for each 
of the fiscal years 2015 through 2018. 
Æ 
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