HR4150-119

1. Short title This Act may be cited as the Advancing Maternal Health Equity Under Medicaid Act.

2. Higher FMAP for increased expenditures under medicaid for maternal health services Section 1903 of the Social Security Act (42 U.S.C. 1396b) is amended— in subsection (a)(5)— by striking an amount equal and inserting (A) an amount equal; and by adding at the end the following: and for calendar quarters beginning on or after January 1 of the year beginning after one year after the date of the enactment of this subparagraph, an amount equal to 90 percent of the amounts by which— the sum of the amounts expended which are attributable to the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or waiver of the plan) of maternal health care services (as described in subsection (b)(6)(B)) for such quarter, exceeds the sum of the amounts expended which are attributable to the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or waiver of the plan) of such services for the corresponding quarter in the four-quarter period ending on December 31, 2019, plus in subsection (b), by adding at the end the following new paragraph: As conditions for receiving the funds the Secretary is otherwise obligated to pay to a State under subsection (a)(5)(B), a State shall meet the following requirements: The State shall use the funds received under such subsection to supplement, not supplant, the level of State funds expended for the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or under a waiver of the plan) of maternal health care services (as described in subparagraph (B)) through programs and activities in effect as of January 1, 2023. The State shall use the funds received under such subsection for activities that increase the capacity, efficiency, and quality in the provision of maternal health care services. For purposes of this paragraph and subsection (a)(5)(B): Maternal health care services described in this subparagraph are services furnished by a maternity care provider or perinatal health worker, such as the following: Prenatal, labor and delivery, and postpartum health care services that are furnished in a licensed and accredited hospital, birth center, midwifery practice, or other health care practice that provides prenatal services, labor and delivery services, and postpartum services. Telehealth services during the prenatal and postpartum periods. Home visiting services during the prenatal and postpartum periods. Mental or behavioral health care services for individuals during the prenatal and postpartum periods. The term maternity care provider means a health care provider who— is a physician, physician assistant, midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives, nurse practitioner, or clinical nurse specialist; and has a focus on maternal or perinatal health. The term perinatal health worker means a doula, community health worker, breastfeeding and lactation educator or counselor, nutritionist or dietitian, childbirth educator, social worker, home visitor, or language interpreter. The terms postpartum and postpartum period each refer to the 1-year period beginning on the last day of the pregnancy of an individual. and (B)for calendar quarters beginning on or after January 1 of the year beginning after one year after the date of the enactment of this subparagraph, an amount equal to 90 percent of the amounts by which— (i)the sum of the amounts expended which are attributable to the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or waiver of the plan) of maternal health care services (as described in subsection (b)(6)(B)) for such quarter, exceeds (ii)the sum of the amounts expended which are attributable to the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or waiver of the plan) of such services for the corresponding quarter in the four-quarter period ending on December 31, 2019, plus; and (6)Accountability and maintenance of effort requirements for additional federal funding for increased expenditures for maternal health care services (A)In generalAs conditions for receiving the funds the Secretary is otherwise obligated to pay to a State under subsection (a)(5)(B), a State shall meet the following requirements: (i)Supplement, not supplantThe State shall use the funds received under such subsection to supplement, not supplant, the level of State funds expended for the offering, arranging, and furnishing (directly or on a contract basis) under the State plan (or under a waiver of the plan) of maternal health care services (as described in subparagraph (B)) through programs and activities in effect as of January 1, 2023. (ii)Use of funds for activities that improve delivery of maternal health care servicesThe State shall use the funds received under such subsection for activities that increase the capacity, efficiency, and quality in the provision of maternal health care services. (B)DefinitionsFor purposes of this paragraph and subsection (a)(5)(B): (i)Maternal health care servicesMaternal health care services described in this subparagraph are services furnished by a maternity care provider or perinatal health worker, such as the following: (I)Prenatal, labor and delivery, and postpartum health care services that are furnished in a licensed and accredited hospital, birth center, midwifery practice, or other health care practice that provides prenatal services, labor and delivery services, and postpartum services. (II)Telehealth services during the prenatal and postpartum periods. (III)Home visiting services during the prenatal and postpartum periods. (IV)Mental or behavioral health care services for individuals during the prenatal and postpartum periods. (ii)Maternity care providerThe term maternity care provider means a health care provider who— (I)is a physician, physician assistant, midwife who meets at a minimum the international definition of the midwife and global standards for midwifery education as established by the International Confederation of Midwives, nurse practitioner, or clinical nurse specialist; and (II)has a focus on maternal or perinatal health. (iii)Perinatal health workerThe term perinatal health worker means a doula, community health worker, breastfeeding and lactation educator or counselor, nutritionist or dietitian, childbirth educator, social worker, home visitor, or language interpreter. (iv)Postpartum and postpartum periodThe terms postpartum and postpartum period each refer to the 1-year period beginning on the last day of the pregnancy of an individual..