H.R. 9061: Preeclampsia Risk Evaluation and Evidence-based Management through Personalized Testing Act

This bill, titled the Preeclampsia Risk Evaluation and Evidence-based Management through Personalized Testing Act, aims to improve the early detection and management of preeclampsia through Medicaid and the Children’s Health Insurance Program (CHIP). Below are the key points of what the bill proposes:

Purpose of the Bill

• The bill seeks to require the Secretary of Health and Human Services to provide guidance to States on coverage for screening and detection tests for preeclampsia under Medicaid and CHIP.

Significant Findings

• Preeclampsia affects about 5 to 8 percent of pregnancies globally, leading to approximately 70,000 maternal deaths and 500,000 fetal deaths annually in the U.S.
• Black women are significantly more likely to experience severe outcomes related to preeclampsia compared to White women.
• Preeclampsia is a leading cause of maternal mortality and morbidity, accounting for up to 15 percent of maternal deaths, particularly in high-risk populations.
• The condition contributes significantly to preterm births, representing 15 to 20 percent of all such cases in the U.S.
• The economic burden of preeclampsia in the U.S. exceeds $2 billion annually, including healthcare costs and losses from long-term health issues.
• Risk factors for preeclampsia include maternal age, obesity, chronic hypertension, multiple pregnancies, and certain autoimmune diseases.
• Women who develop preeclampsia have a higher risk of long-term cardiovascular issues, such as chronic hypertension and heart disease.

Key Provisions of the Bill

• The Secretary of Health and Human Services is mandated to issue guidance within 180 days of the bill’s enactment, detailing best practices for improving outcomes for pregnant women with preeclampsia.
• This guidance will include recommendations on which tests can be provided as medical assistance for early detection and management of the condition.
• The bill emphasizes the inclusion of biomarker tests for preeclampsia that are regulated and cleared under relevant health laws.
• States can request technical assistance from the Secretary to determine whether specific tests can be offered under their Medicaid plans without making such requests mandatory.

Technical Assistance

• The Secretary will provide assistance to States on request, within 30 days, regarding the medical assistance for specific tests related to preeclampsia.
• States are not required to request this assistance to provide medical assistance for tests or to receive federal funding.

Specific Tests to Consider

• The bill highlights the consideration of advanced biomarker tests for preeclampsia, including those regulated as medical devices and laboratory-developed tests certified for complex testing.

Expected Outcomes

• Increased awareness and implementation of best practices for early detection and management of preeclampsia among healthcare providers.
• Potential improvements in pregnancy outcomes for women at risk of developing preeclampsia, ultimately reducing maternal and fetal mortality rates.
• Enhanced access to screening and detection tests for women enrolled in Medicaid and CHIP, especially among high-risk groups.

Relevant Companies

• None found