Optimizing Postpartum Outcomes Act of 2022
Bill: H.R.8181 | Sponsor: Rep. Herrera Beutler, Jaime (R-WA)
Policy area: Health

Summary:
Optimizing Postpartum Outcomes Act of 2022
This bill requires (1) the Centers for Medicare & Medicaid Services to issue guidance to support coverage of prenatal and postpartum pelvic health services under Medicaid and the Children's Health Insurance Program (CHIP), (2) the Government Accountability Office to study gaps in Medicaid coverage of these and other services for postpartum women, and (3) the Centers for Disease Control and Prevention to educate health professionals and postpartum women on pelvic health services.

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 Representatives 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''.

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 Insurance 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 increase access to covered 
        pelvic health services;
            (2) recommendations for States on available financing 
        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 Program under 
                title XXI of such Act (42 U.S.C. 1397aa et seq.), 
                specifically funds made available through a Children's 
                Health Insurance Program Health Services Initiative;
            (3) guidance and technical assistance to State agencies 
        responsible for administering 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.) 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 Classification 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:
            (1) The term ``postpartum period'' means the longer of the 
        period of lactation or the 6-month period beginning on the last 
        day of a woman's pregnancy.
            (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 defined in 
                such section 317L-2).

SEC. 3. POSTPARTUM PELVIC HEALTH EDUCATION CAMPAIGN.

    Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 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 Prevention, in collaboration with 
the Administrator of the Health Resources and Services Administration 
and the heads of other agencies, and in consultation with appropriate 
health professional associations, shall develop and carry out a 
program--
            ``(1) to educate and train health professionals on pelvic 
        floor examinations and the benefits of pelvic health physical 
        therapy; and
            ``(2) to educate postpartum women on--
                    ``(A) with respect to pelvic floor examinations--
                            ``(i) the importance of such examinations 
                        during the postpartum period;
                            ``(ii) how to obtain such an examination, 
                        including information relating to obtaining 
                        referrals; and
                            ``(iii) what is involved in such an 
                        examination; 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 performance, 
                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 fascia, and the position of the organs.
            ``(2) The term `pelvic health physical therapy' means a 
        personalized physical therapy plan implemented 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, 
        recover from injury, prevent future injury, and manage pain and 
        chronic conditions.
            ``(3) The term `pelvic health related condition' includes 
        urinary dysfunction, bowel dysfunction, musculoskeletal 
        dysfunction, sexual dysfunction, cancer-related rehabilitation, 
        and the pre-partum state and pre-partum conditions.
    ``(c) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $2,000,000 for each of fiscal 
years 2023 through 2027.''.
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