[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2598 Introduced in House (IH)]
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117th CONGRESS
1st Session
H. R. 2598
To amend title XVIII, XIX, and XXI of the Social Security Act and title
XXVII of the Public Health Service Act to expand access to maternal
health care, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 15, 2021
Ms. Pressley introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committees on
Ways and Means, and Education and Labor, for a period to be
subsequently determined by the Speaker, in each case for consideration
of such provisions as fall within the jurisdiction of the committee
concerned
_______________________________________________________________________
A BILL
To amend title XVIII, XIX, and XXI of the Social Security Act and title
XXVII of the Public Health Service Act to expand access to maternal
health care, 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 ``COVID-19 Safe Birthing Act''.
SEC. 2. EXPANDING ACCESS TO MATERNAL CARE IN HOSPITALS.
Section 1866(a)(1) of the Social Security Act (42 U.S.C.
1395cc(a)(1)) is amended--
(1) in subparagraph (X), by striking at the end ``and'';
(2) in subparagraph (Y)(ii)(V), by striking the period at
the end and inserting ``; and''; and
(3) by inserting after subparagraph (Y)(ii)(V), the
following new subparagraph:
``(Z) beginning 30 days after the date of enactment
of this subparagraph, in the case of a hospital--
``(i) to require that such hospital permits
a pregnant or birthing person to be accompanied
by an individual of the pregnant or birthing
person's choosing (in addition to a doula or
other perinatal health worker) during labor,
delivery, and recovery; with necessary,
evidence based, and non-discriminatory
exceptions;
``(ii) to require that such hospital does
not implement any policies that restrict
hospital access or birthing options for
pregnant or birthing persons, unless such
policies are necessary, evidence-based,
communicated to the patient without threat or
intimidation, and applied without
discrimination on the basis of race, gender
identity, socio-economic status, religion,
sexual orientation, marital status, age,
disability, national origin, and immigration
status; and
``(iii) with respect to the care of a
pregnant or birthing person, to require the
communication of and informed consent (without
threat or intimidation) to the implementation
of policies pursuant to clause (ii) by the
pregnant or birthing person, in accordance with
consent protocols of the hospital in the case
of inability of a person to provide consent.''.
SEC. 3. EXPANDING MEDICARE AND MEDICAID COVERAGE OF TELEHEALTH SERVICES
THAT ARE MATERNAL HEALTH CARE SERVICES.
(a) Removal of Certain Medicare Requirements for Maternal Health
Care Services.--Section 1834(m) of the Social Security Act (42 U.S.C.
1395m(m)) is amended--
(1) in paragraph (4)(C)(i), by striking ``paragraphs (5),
(6), and (7)'' and inserting ``paragraphs (5), (6), (7), and
(9)''; and
(2) by adding at the end the following new paragraph:
``(9) Treatment of maternity health care services.--With
respect to telehealth services that are maternal health care
services, notwithstanding any other provision of this
subsection--
``(A) the requirements described in paragraph
(4)(C) shall not apply;
``(B) the term `originating site' means sites at
which the eligible telehealth individual is located at
the time the service is furnished via a
telecommunications system; and
``(C) there shall be no restrictions on access to
such telehealth services through use of telephone based
on the use of video capabilities or lack of such
capabilities.''.
(b) Medicaid Coverage.--Section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) is amended--
(1) in paragraph (5)(A), by inserting ``(and in the case of
physicians' services that are maternal health care services,
including via telehealth)'' after ``or elsewhere'';
(2) in paragraph (17), by inserting ``, including services
furnished via telehealth,'' before ``furnished'';
(3) in paragraph (21), by inserting ``, including services
furnished via telehealth,'' after ``furnished''; and
(4) in paragraph (28), by inserting ``, including such
services furnished via telehealth to the extent such services
may be performed under State law by freestanding birth
centers'' before the semicolon at the end.
SEC. 4. ENSURING COVERAGE OF CERTAIN MATERNAL HEALTH CARE SERVICES.
(a) Making Certain Medicaid Coverage of Certain Prenatal and
Postpartum Services a State Plan Requirement.--
(1) State medicaid plans.--
(A) In general.--Section 1902 of the Social
Security Act (42 U.S.C. 1396a) is amended--
(i) in subsection (a)--
(I) in paragraph (86), by striking
``and'' at the end;
(II) in paragraph (87), by striking
at the end the period and inserting ``;
and''; and
(III) by inserting after paragraph
(87) the following new paragraph:
``(88) provide that the State plan is in compliance with
subsection (e)(16).''; and
(ii) in subsection (e)(16)--
(I) in subparagraph (A), by
striking ``At the option of the State,
the State plan (or waiver of such State
plan) may provide'' and inserting ``A
State plan (or waiver of such State
plan) shall provide'';
(II) in subparagraph (B)--
(aa) in the matter
preceding clause (i), by
striking ``by a State making an
election under this paragraph''
and inserting ``under a State
plan (or a waiver os such State
plan)'';
(bb) in clause (i), by
striking at the end ``and'';
(cc) in clause (ii), by
striking the period at the end
and inserting ``; and''; and
(dd) by adding at the end
the following new clause:
``(iii) include as pregnancy-related
medical assistance a comprehensive number of
prenatal appointments and screenings furnished
by a maternity care provider (as defined in
section 2730(b)(1) of the Public Health Service
Act), perinatal health worker (as defined in
section 2730(b)(2) of the Public Health Service
Act), or community-based provider and as
postpartum-related medical assistance a full-
spectrum of postpartum care furnished by such a
provider.''; and
(III) by striking subparagraph (C).
(B) No cost sharing or similar charges for certain
services.--Section 1916(a)(2) of the Social Security
Act (42 U.S.C. 1396o(a)(2)) is amended--
(i) in subparagraph (F), by striking at the
end ``or'';
(ii) in subparagraph (G), by striking ``;
and'' and inserting ``; or''; and
(iii) by adding at the end the following
new subparagraph:
``(H) appointments, screenings, and
care required to be included as
pregnancy-related and postpartum-
related medical assistance under
section 1902(e)(16)(B)(iii); and''.
(2) Applying requirement under chip.--Section 2107(e)(1)(J)
of the Social Security Act (42 U.S.C. 1397gg(e)(1)(J)) is
amended to read as follows:
``(J) Paragraphs (5) and (16) of section 1902(e)
(relating to the requirement to provide medical
assistance under the State plan or waiver consisting of
full benefits during pregnancy and throughout the 12-
month postpartum period under title XIX) such that the
provision of assistance under the State child health
plan or waiver for targeted low-income children or
targeted low-income pregnant women during pregnancy and
the 12-month postpartum period shall be required and
shall include coverage of all items or services
provided to a targeted low-income child or targeted
low-income pregnant woman (as applicable) under the
State child health plan or waiver), including the
appointments, screenings, and care required to be
included as pregnancy-related and postpartum-related
medical assistance under section
1902(e)(16)(B)(iii).''.
(3) Effective date.--
(A) In general.--Except as provided in paragraph
(2), the amendments made by this section shall take
effect on the date of the enactment of this Act and
shall apply to services furnished on or after the date
that is 30 days after the date of enactment of this
Act.
(B) Exception if state legislation required.--In
the case of a State plan for medical assistance under
title XIX of the Social Security Act or State child
health plan for child health assistance under title XXI
of such Act which the Secretary of Health and Human
Services determines requires State legislation (other
than legislation appropriating funds) in order for the
plan to meet the additional requirement imposed by the
amendments made by this subsection, the State plan or
State child health plan shall not be regarded as
failing to comply with the requirements of such title
solely on the basis of its failure to meet this
additional requirement before the first day of the
first calendar quarter beginning after the close of the
first regular session of the State legislature that
begins after the date of the enactment of this Act. For
purposes of the previous sentence, in the case of a
State that has a 2-year legislative session, each year
of such session shall be deemed to be a separate
regular session of the State legislature.
(b) Private Health Plans.--Subpart II of part A of title XXVII of
the Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is amended
by adding at the end the following new section:
``SEC. 2730. COVERAGE OF PRENATAL AND POSTPARTUM SERVICES.
``(a) In General.--Beginning 30 days after the date of enactment of
this section, a group health plan and a health insurance issuer
offering group or individual health insurance coverage shall provide
coverage for and shall not impose any cost sharing requirements for--
``(1) a comprehensive number of prenatal appointments and
screenings furnished by a maternity care provider, perinatal
health worker, or community-based provider; and
``(2) a full-spectrum of postpartum care furnished by such
a provider for at least a year after birth or the end of
pregnancy.
``(b) Definitions.--For purposes of this section:
``(1) Maternity care provider.--The term `maternity care
provider' means a health care provider who--
``(A) is a physician, physician assistant, or
midwife who meets at a minimum the international
definition of the midwife and global standards for
midwifery education as established by the International
Confederation of Midwives, nurse practitioner, or
clinical nurse specialist; and
``(B) has a focus on maternal or perinatal health.
``(2) Perinatal health worker.--The term `perinatal health
worker' means a doula, community health worker, peer supporter,
breastfeeding and lactation educator or counselor, nutritionist
or dietitian, childbirth educator, social worker, home visitor,
language interpreter, or navigator.''.
SEC. 5. ENSURING FREE TESTING, VACCINE, AND TREATMENT FOR COVID-19 TO
PREGNANT PERSONS AND TO INFANTS, REGARDLESS OF INSURANCE
STATUS OR SOURCE OF INSURANCE.
(a) Expansion of Coverage of Testing for COVID-19 to Other Private
Plans.--Section 6001(a) of the Families First Coronavirus Response Act
(Public Law 116-127) is amended by striking ``A group health plan and a
health insurance issuer offering group or individual health insurance
coverage (including a grandfathered health plan (as defined in section
1251(e) of the Patient Protection and Affordable Care Act))'' and
inserting ``A group health plan, a health insurance issuer offering
group or individual health insurance coverage (including a
grandfathered health plan (as defined in section 1251(e) of the Patient
Protection and Affordable Care Act)), short-term limited duration
insurance, association health plans and health care sharing
ministries''.
(b) Requirement To Provide Coverage for COVID-19 Treatment After
the COVID-19 Emergency Period.--
(1) State medicaid plans.--
(A) Plans with traditional cost sharing.--
Subsections (a)(2)(F) and (b)(2)(F) of section 1916 of
the Social Security Act (42 U.S.C. 1396o) are each
amended by striking ``that is administered during any
portion of the emergency period described in such
section beginning on or after the date of the enactment
of this subparagraph (and the administration of such
product)''.
(B) Plans with alternative cost sharing.--Section
1916A(b)(3)(B)(xi) of the Social Security Act (42
U.S.C. 1396o-1(b)(3)(B)(xi)) is amended by striking
``that is furnished during any such portion''.
(2) Private plans.--Section 6001(a) of the Families First
Coronavirus Response Act (Public Law 116-127), as amended by
paragraph (1), is further amended by striking ``furnished
during any portion of the emergency period defined in paragraph
(1)(B) of section 1135(g) of the Social Security Act (42 U.S.C.
1320b-5(g)) beginning on or after the date of the enactment of
this Act''.
(c) State Medicaid Plan Requirement To Provide Coverage of Testing
for COVID-19 for Uninsured Pregnant Persons.--Section 1902(a)(10) of
the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended--
(1) in subparagraph (F), by striking at the end ``and'';
(2) in subparagraph (G), by adding at the end ``and''; and
(3) by inserting after subparagraph (G) the following new
subparagraph:
``(H) for making a clinical diagnostic laboratory
test administered for the detection of SARS-CoV-2 or
the diagnosis of the virus that causes COVID-19 and the
administration of such test available to an uninsured
pregnant individual.''.
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