H.R. 8907

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8907 Introduced in House (IH)]

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119th CONGRESS
2d Session
H. R. 8907

To direct the Administrator of the Centers for Medicare & Medicaid 
Services to implement the Perinatal Care Alternative Payment Model 
Demonstration Project to test various payment models with respect to 
maternity care provided to pregnant and postpartum individuals, and for 
other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

May 19, 2026

Ms. Schakowsky (for herself, Ms. Barragan, Ms. Budzinski, Mr. Carbajal, 
Ms. Clarke of New York, Mr. Cleaver, Mr. Cohen, Ms. Craig, Mr. Davis of 
Illinois, Ms. Dean of Pennsylvania, Ms. DelBene, Mr. Evans of 
Pennsylvania, Mr. Garamendi, Ms. Garcia of Texas, Mr. Gottheimer, Mrs. 
Hayes, Mr. Huffman, Mr. Krishnamoorthi, Mr. Lynch, Ms. McCollum, Ms. 
McClellan, Mr. Meeks, Ms. Meng, Mr. Morelle, Ms. Moore of Wisconsin, 
Mr. Moulton, Mr. Mullin, Ms. Pressley, Mr. Schneider, Ms. Sewell, Ms. 
Simon, Mr. Smith of Washington, Ms. Strickland, Ms. Stansbury, Mrs. 
Sykes, Mr. Takano, Ms. Tlaib, Mr. Tonko, Mrs. Torres of California, 
Mrs. Trahan, Mr. Vargas, Mr. Veasey, and Ms. Williams of Georgia) 
introduced the following bill; which was referred to the Committee on 
Energy and Commerce

_______________________________________________________________________

A BILL

To direct the Administrator of the Centers for Medicare & Medicaid 
Services to implement the Perinatal Care Alternative Payment Model 
Demonstration Project to test various payment models with respect to 
maternity care provided to pregnant and postpartum individuals, 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 ``Innovative Maternal Payment and 
Coverage To Save Moms Act'' or the ``IMPACT to Save Moms Act''.

SEC. 2. PERINATAL CARE ALTERNATIVE PAYMENT MODEL DEMONSTRATION PROJECT.

(a) In General.--For the period of fiscal years 2027 through 2031, 
the Secretary of Health and Human Services (referred to in this section 
as the ``Secretary''), acting through the Administrator of the Centers 
for Medicare & 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 (referred 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 
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.) 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 Demonstration Project, the 
Secretary shall coordinate with stakeholders such as--
(1) State Medicaid programs;
(2) maternity care providers and organizations representing 
maternity care providers;
(3) relevant organizations representing patients, with a 
particular focus on patients from demographic groups with 
elevated rates of maternal mortality, severe maternal 
morbidity, maternal health disparities, or other adverse 
perinatal or childbirth outcomes;
(4) relevant community-based organizations, particularly 
organizations that seek to improve maternal health outcomes for 
individuals from demographic groups with elevated rates of 
maternal mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth outcomes;
(5) perinatal health workers;
(6) relevant health insurance issuers;
(7) hospitals, health systems, midwifery practices, 
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 defined in section 
1861(aa) of such Act (42 U.S.C. 1395x(aa)));
(8) researchers and policy experts in fields related to 
maternity care payment models; and
(9) any other stakeholders as the Secretary determines 
appropriate, with a particular focus on stakeholders from 
demographic groups with elevated rates of maternal mortality, 
severe maternal morbidity, maternal health disparities, or 
other adverse perinatal or childbirth outcomes.
(c) Considerations.--In establishing the Demonstration Project, the 
Secretary shall consider any alternative payment model that--
(1) is designed to improve maternal health outcomes for 
individuals from demographic groups with elevated rates of 
maternal mortality, severe maternal morbidity, maternal health 
disparities, or other adverse perinatal or childbirth outcomes;
(2) includes methods for stratifying patients by pregnancy 
risk level and, as appropriate, adjusting payments under such 
model to take into account pregnancy risk level, including 
consideration of the appropriate transfer of patients by 
pregnancy risk level;
(3) establishes evidence-based quality metrics for such 
payments;
(4) includes consideration of nonhospital birth settings 
such as freestanding birth centers (as so defined);
(5) includes consideration of social determinants of 
maternal health;
(6) includes diverse maternity care teams that include--
(A) maternity care providers, mental and behavioral 
health care providers acting in accordance with State 
law, and registered dietitians or nutrition 
professionals (as such term is defined in section 
1395x(vv)(2) of title 42, United States Code)--
(i) from racially, ethnically, and 
professionally diverse backgrounds;
(ii) with experience practicing in racially 
and ethnically diverse communities; or
(iii) who have undergone training on 
implicit bias and racism; and
(B) perinatal health workers; or
(7) includes consideration of maternal mental health 
conditions and substance use disorders.
(d) Eligibility.--To be eligible to participate in the 
Demonstration Project, a State shall submit an application 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 stratified by race, 
ethnicity, primary language, socioeconomic status, geography, 
insurance type, and other factors as the Secretary determines 
appropriate;
(2) spending on maternity care by States participating in 
the Demonstration Project;
(3) to the extent practicable, qualitative and quantitative 
measures of patient experience; and
(4) any other areas of assessment that the Secretary 
determines relevant.
(f) Report.--Not later than one year after the completion or 
termination date of the Demonstration Project, the Secretary shall 
submit to the Congress, and make publicly available, a report 
containing--
(1) the results of any evaluation conducted under 
subsection (e); and
(2) a recommendation regarding whether the Demonstration 
Project should be continued after fiscal year 2031 and expanded 
on a national basis.
(g) Definitions.--In this section:
(1) Alternative payment model.--The term ``alternative 
payment model'' has the meaning given such term in section 
1833(z)(3)(C) of the Social Security Act (42 U.S.C. 
1395l(z)(3)(C)).
(2) Maternal mortality.--The term ``maternal mortality'' 
means a death occurring during or within a 1-year period after 
pregnancy, caused by pregnancy-related or childbirth 
complications, including a suicide, overdose, or other death 
resulting from a mental health or substance use disorder 
attributed to or aggravated by pregnancy-related or childbirth 
complications.
(3) Maternity care provider.--The term ``maternity care 
provider'' means a health care provider who--
(A) is a physician, a physician assistant, a 
midwife who meets, at a minimum, the international 
definition of a midwife and global standards for 
midwifery education as established by the International 
Confederation of Midwives, an advanced practice 
registered nurse, a doula accredited by a State to 
receive reimbursement for doula services under a State 
plan (or a waiver of such plan) under title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.), or a 
lactation consultant certified by the International 
Board of Lactation Consultant Examiners; and
(B) has a focus on maternal or perinatal health.
(4) Perinatal.--The term ``perinatal'' means the period 
beginning on the day an individual becomes pregnant and ending 
on the last day of the 1-year period beginning on the last day 
of such individual's pregnancy.
(5) Perinatal health worker.--The term ``perinatal health 
worker'' means a nonclinical health worker focused on maternal 
or perinatal health, such as a doula, community health worker, 
peer supporter, lactation educator or counselor, nutritionist 
or dietitian, childbirth educator, social worker, home visitor, 
patient navigator or coordinator, or language interpreter.
(6) Postpartum and postpartum period.--The terms 
``postpartum'' and ``postpartum period'' refer to the 1-year 
period beginning on the last day of the pregnancy of an 
individual.
(7) Severe maternal morbidity.--The term ``severe maternal 
morbidity'' means a health condition, including mental health 
conditions and substance use disorders, attributed to or 
aggravated by pregnancy or childbirth that results in 
significant short-term or long-term consequences to the health 
of the individual who was pregnant.
(8) Social determinants of maternal health.--The term 
``social determinants of maternal health'' means nonclinical 
factors that impact maternal health outcomes.
(h) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as are necessary to carry out this section.
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