S. 4480: Optimizing Postpartum Outcomes Act of 2026

This legislation, titled the Optimizing Postpartum Outcomes Act of 2026, aims to enhance postpartum pelvic health care services in the United States, particularly for women enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). Here are the key components:

Guidance for Medicaid Coverage

The bill mandates that the Secretary of Health and Human Services (HHS) must develop and issue guidance within one year of the bill's enactment. This guidance will pertain to:

• Best Practices: Identifying innovative and evidence-based payment models from various states to improve access to pelvic health services.
• Financing Options: Recommending available funding mechanisms for states under Medicaid and CHIP to support pelvic health services.
• Flexibilities and Incentives: Offering assistance to state agencies on additional flexibilities related to screening and access to pelvic health services.
• Terminology and Diagnosis Codes: Providing guidance on suggested terminology and diagnosis codes for identifying women with pelvic floor dysfunctions.

Research Study

The legislation also requires the Government Accountability Office (GAO) to conduct a study within a year following the enactment. The report will focus on:

• Identifying gaps in coverage for pelvic health services under Medicaid for postpartum women.
• Evaluating other services available to postpartum women who received medical assistance during pregnancy.

Postpartum Pelvic Health Education Campaign

The bill calls for the establishment of an educational program led by the Centers for Disease Control and Prevention (CDC) in collaboration with various health agencies. This program aims to:

• Educate health professionals on conducting pelvic floor examinations and the benefits of pelvic health physical therapy.
• Inform postpartum women about the importance of pelvic floor examinations, how to get them, and the nature of the examinations.
• Advise women on the benefits and availability of pelvic health physical therapy and how to obtain referrals.

Definitions and Authorizations

The act defines key terms such as:

• Postpartum Period: The duration defined as either the period of lactation or six months starting from the end of a pregnancy.
• Covered Pelvic Health Services: This includes pelvic floor examinations and pelvic health physical therapy as defined within the bill.

To facilitate the implementation of these programs and services, the bill allocates $2,000,000 annually from fiscal years 2027 through 2031.

Relevant Companies

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