S. 4482

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 4482 Introduced in Senate (IS)]

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119th CONGRESS
2d Session
S. 4482

To amend title XVIII of the Social Security Act to require hospitals to 
develop discharge plans for pregnant individuals as a condition of 
participation under Medicare, and for other purposes.

_______________________________________________________________________

IN THE SENATE OF THE UNITED STATES

May 11, 2026

Ms. Blunt Rochester introduced the following bill; which was read twice 
and referred to the Committee on Finance

_______________________________________________________________________

A BILL

To amend title XVIII of the Social Security Act to require hospitals to 
develop discharge plans for pregnant individuals as a condition of 
participation under Medicare, 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 ``Women Expansion of Learning and 
Labor Safety Act'' or the ``WELLS Act''.

SEC. 2. REQUIRING HOSPITALS PARTICIPATING IN MEDICARE TO DEVELOP 
DISCHARGE PLANS FOR PREGNANT INDIVIDUALS.

Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is 
amended--
(1) in subsection (a)(1)--
(A) in subparagraph (X), by striking ``and'' at the 
end;
(B) in subparagraph (Y), by striking the period at 
the end and inserting ``, and''; and
(C) by adding at the end the following new 
subparagraph:
``(Z) beginning January 1, 2027, in the case of a hospital, 
critical access hospital, or rural emergency hospital, to 
comply with the requirements described in subsection (l)(1).''; 
and
(2) by adding at the end the following new subsection:
``(l) Discharge Plan Requirements for Pregnant Individuals.--
``(1) In general.--For purposes of subsection (a)(1)(Z), 
the requirements described in this paragraph are, with respect 
to a hospital, critical access hospital, or rural emergency 
hospital, that the hospital--
``(A) provides for the development and 
implementation of a discharge plan meeting the 
standards under paragraph (2) with respect to any 
individual (whether or not eligible for benefits under 
this title) admitted to the hospital who--
``(i) is pregnant;
``(ii) is experiencing signs or symptoms 
consistent with labor, which may include 
contractions; and
``(iii) is expected to be discharged from 
the hospital, critical access hospital, or 
rural emergency hospital prior to delivery, as 
determined based on the documented clinical 
judgment of the treating physician or 
practitioner at the time that such discharge is 
contemplated;
``(B) includes such discharge plan in the 
individual's medical record; and
``(C) provides for such discharge plan to be 
discussed with the individual (or the individual's 
representative) prior to discharge.
``(2) Discharge plan standards.--A discharge plan for an 
individual described in paragraph (1)(A) meets the standards 
under this paragraph if such plan includes at least the 
following information:
``(A) A clinical justification for the discharge.
``(B) An assessment of travel distance and time 
between the primary residence of the individual and the 
hospital, critical access hospital, or rural emergency 
hospital.
``(C) Verification of reliable transportation 
between the primary residence of the individual and the 
hospital, critical access hospital, or rural emergency 
hospital.
``(D) Identification of a secondary hospital or 
facility at which such individual may obtain labor and 
delivery services.
``(E) Confirmation that the plan was reviewed and 
approved by a registered professional nurse, social 
worker, or other appropriately qualified personnel.
``(F) Confirmation that the individual (or the 
individual's representative) has received the 
information described in subparagraphs (A) through (D), 
that such information was provided in the primary 
language of such individual (or representative), and 
that such individual (or representative) confirmed 
their understanding of such information.
``(3) Rule of construction.--Nothing in this subsection 
shall be construed as limiting or otherwise affecting the 
discharge planning requirements otherwise applicable to a 
hospital, critical access hospital, or rural emergency hospital 
under this title, or any obligation of a health care provider 
to furnish emergency services as required under State or 
Federal law, including section 1867 of this title (commonly 
known as the `Emergency Medical Treatment and Labor Act').''.

SEC. 3. RURAL MATERNAL AND OBSTETRIC CARE TRAINING DEMONSTRATION 
GRANTS.

Section 764 of the Public Health Service Act (42 U.S.C. 294s) is 
amended--
(1) by redesignating subsections (d) and (e) as subsections 
(e) and (f), respectively;
(2) by inserting after subsection (c) the following:
``(d) Minimum Performance Milestones.--
``(1) Establishment.--Beginning with the grants awarded 
under this section for fiscal year 2027, the Secretary shall 
establish minimum performance milestones that grant recipients 
must meet during a fiscal year as a condition of remaining 
eligible for funding through such a grant for any subsequent 
fiscal year.
``(2) Milestones related to percent of staff trained.--The 
minimum performance milestones referred to in paragraph (1) 
shall include milestones related to the percent of all staff of 
the grant recipient that are trained, or that receive refresher 
training, with support from a grant under this section.''; and
(3) in subsection (e), as so redesignated--
(A) in the subsection heading, by striking 
``Report'' and inserting ``Reports'';
(B) in paragraph (1)(B), by striking ``the report 
described in paragraph (2)'' and inserting ``the 
reports described in paragraphs (2) and (3)''; and
(C) by adding at the end the following:
``(3) Subsequent reports.--Not later than January 1, 2027, 
and annually thereafter, the Secretary shall submit to 
Congress, and make publicly available, a report that includes--
``(A) updates to the information described in 
subparagraphs (A) through (C) of paragraph (2); and
``(B) additional information regarding the grants 
under this section, including--
``(i) a list of the entities receiving such 
grants;
``(ii) the number and amount of such 
grants;
``(iii) whether training supported by such 
grants was delivered in-person, virtually, 
asynchronously, or through some other format; 
and
``(iv) descriptions of the geographical 
coverage of such grants, the number of 
providers trained under such grants, and 
patient-level metrics linked to such training 
(such as changes in clinical outcomes, patient 
experience, and racial disparities).''.

SEC. 4. MULTI-CENTER IMPLEMENTATION SCIENCE INITIATIVE FOR MATERNAL 
HEALTH.

(a) Establishment.--The Secretary of Health and Human Services, in 
consultation with the Director of the Agency for Healthcare Research 
and Quality and the Director of the National Institutes of Health (in 
this section referred to as the ``Secretary'') shall establish a multi-
center implementation science initiative for maternal health to 
rigorously evaluate different training models for health care 
professionals (including in-person, virtual, simulation, and cohort-
based) and the impact of such models on provider behavior, patient 
outcomes, and maternal health disparities.
(b) Interagency Maternal Health Dashboard.--As part of the 
initiative described in subsection (a), the Secretary shall develop, 
maintain, and make publicly available on the website of the Department 
of Health and Human Services an interagency maternal health dashboard, 
which shall include maternal health outcome metrics from agencies 
within the Department of Health and Human Services.
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