S. 4481: Innovative Maternal Payment and Coverage To Save Moms Act

The bill named the Innovative Maternal Payment and Coverage To Save Moms Act, or IMPACT to Save Moms Act, aims to establish a demonstration project for testing new payment models for maternity care under the Medicaid and Children's Health Insurance Program (CHIP). Here are the key elements of the bill:

1. Purpose of the Demonstration Project

The main goal is to allow states to experiment with different payment models for maternity care. This project is set to run from fiscal years 2027 through 2031 and will focus on care provided to pregnant and postpartum individuals enrolled in state Medicaid and CHIP plans.

2. Coordination with Stakeholders

The Secretary of Health and Human Services will coordinate with various stakeholders in establishing the project, including:

• State Medicaid programs
• Maternity care providers and their organizations
• Organizations representing patients, especially those from groups with high rates of maternal health issues
• Community-based organizations focused on improving maternal health outcomes
• Perinatal health workers
• Health insurance issuers
• Hospitals, health systems, midwifery practices, and birth centers
• Researchers and policy experts in maternity care
• Other relevant stakeholders as deemed appropriate

3. Considerations for Payment Models

In creating these new payment models, the Secretary will consider several factors, including:

• Improvement of maternal health outcomes, particularly for high-risk demographic groups
• Methods for adjusting payments based on pregnancy risk levels
• Establishment of evidence-based quality metrics for care
• Inclusion of non-hospital birth settings like birth centers
• Social determinants of maternal health
• Diversity among maternity care teams
• Addressing maternal mental health and substance use disorders

4. Eligibility and Application

States wishing to participate in the demonstration project must submit an application, following specific guidelines set by the Secretary.

5. Evaluation of the Project

The Secretary will evaluate the demonstration project to assess its impact on:

• Maternal health outcomes, categorized by factors such as race, ethnicity, and socioeconomic status
• State spending on maternity care
• Patient experience measurements
• Other assessment areas as deemed necessary

6. Reporting Requirements

Within a year after the project's conclusion, the Secretary must submit a report to Congress, detailing the evaluation results and making recommendations on whether the project should continue or be expanded nationally.

7. Funding

The bill authorizes the necessary appropriations to implement the project.

8. Definitions

Relevant definitions in the bill include:

• Alternative payment model: Defined under the Social Security Act.
• Perinatal: Refers to the period from when an individual becomes pregnant to one year after the pregnancy ends.

Relevant Companies

• None found