[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4074 Introduced in House (IH)]
<DOC>
119th CONGRESS
1st Session
H. R. 4074
To direct the Secretary of Health and Human Services to issue guidance
on coverage under the Medicaid program under title XIX of the Social
Security Act of certain pelvic health services furnished during the
postpartum period, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 23, 2025
Mr. Bacon (for himself and Mrs. Trahan) introduced the following bill;
which was referred to the Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To direct the Secretary of Health and Human Services to issue guidance
on coverage under the Medicaid program under title XIX of the Social
Security Act of certain pelvic health services furnished during the
postpartum period, 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 ``Optimizing Postpartum Outcomes Act
of 2025''.
SEC. 2. CMS GUIDANCE.
(a) In General.--Not later than 1 year after the date of the
enactment of this Act, the Secretary of Health and Human Services shall
issue guidance on coverage under State plans (or waivers of such plans)
under the Medicaid program under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.) or State child health plans (or waivers of
such plans) under the Children's Health Insurance Program under title
XXI of such Act (42 U.S.C. 1397aa et seq.) of covered pelvic health
services furnished during the prenatal or postpartum period. Such
guidance shall include--
(1) best practices from States with respect to innovative
or evidenced-based payment models to increase access to covered
pelvic health services;
(2) recommendations for States on available financing
options under--
(A) the Medicaid program under title XIX of such
Act (42 U.S.C. 1396 et seq.); and
(B) the Children's Health Insurance Program under
title XXI of such Act (42 U.S.C. 1397aa et seq.),
specifically funds made available through a Children's
Health Insurance Program Health Services Initiative;
(3) guidance and technical assistance to State agencies
responsible for administering State plans (or waivers of such
plans) under the Medicaid program under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) regarding additional
flexibilities and incentives related to screening and referral
for, and access to, covered pelvic health services; and
(4) guidance regarding suggested terminology and diagnosis
codes, such as the International Classification of Diseases
code set, to identify women with pelvic floor dysfunction and
disorders.
(b) GAO Study.--Not later than 1 year after the date of the
enactment of this Act, the Comptroller General of the United States
shall conduct a study on, and submit to Congress a report that
addresses, gaps in coverage for--
(1) covered pelvic health services under State plans (or
waivers of such plans) under the Medicaid program under title
XIX of the Social Security Act (42 U.S.C. 1396 et seq.) for
postpartum women; and
(2) other services for postpartum women who received
medical assistance under a State plan (or a waiver of such
plan) under the Medicaid program under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.) during their pregnancy.
(c) Definitions.--In this section:
(1) The term ``postpartum period'' means the longer of the
period of lactation or the 6-month period beginning on the last
day of a woman's pregnancy.
(2) The term ``covered pelvic health services'' means--
(A) pelvic floor examinations (as defined in
section 317L-2 of the Public Health Service Act, as
added by section 2 of this Act); and
(B) pelvic health physical therapy (as defined in
such section 317L-2).
SEC. 3. POSTPARTUM PELVIC HEALTH EDUCATION CAMPAIGN.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 317L-1 (42 U.S.C. 247b-
13a) the following:
``SEC. 317L-2. POSTPARTUM PELVIC HEALTH EDUCATION CAMPAIGN.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, in collaboration with
the Administrator of the Health Resources and Services Administration
and the heads of other agencies, and in consultation with appropriate
health professional associations, shall develop and carry out a
program--
``(1) to educate and train health professionals on pelvic
floor examinations and the benefits of pelvic health physical
therapy; and
``(2) to educate postpartum women on--
``(A) with respect to pelvic floor examinations--
``(i) the importance of such examinations
during the postpartum period;
``(ii) how to obtain such an examination,
including information relating to obtaining
referrals; and
``(iii) what is involved in such an
examination; and
``(B) with respect to pelvic health physical
therapy--
``(i) the benefits of, and availability of
such physical therapy; and
``(ii) how to obtain a referral for such
physical therapy.
``(b) Definitions.--In this section:
``(1) The term `pelvic floor examination' means an
examination to assess a patient for pelvic health related
conditions that is composed of--
``(A) an external evaluation that includes analysis
of posture, joint integrity, muscle performance,
quality of movement, and palpation and observation of
the pelvic floor; and
``(B) if deemed necessary based on the health care
professional's clinical reasoning, an internal vaginal
or rectal examination, or both, to gather relevant
information about the tone, strength, control, ability
to contract and relax the muscles of the pelvic floor
individually and together, the condition of the
surrounding fascia, and the position of the organs.
``(2) The term `pelvic health physical therapy' means a
personalized physical therapy plan implemented by a pelvic
health physical therapist, after performing a pelvic floor
examination and making a diagnosis, that is based on best
available evidence to improve the patient condition, with
respect to the anatomy of the pelvic floor, improve mobility,
recover from injury, prevent future injury, and manage pain and
chronic conditions.
``(3) The term `pelvic health related condition' includes
urinary dysfunction, bowel dysfunction, musculoskeletal
dysfunction, sexual dysfunction, cancer-related rehabilitation,
and the pre-partum state and pre-partum conditions.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $2,000,000 for each of fiscal
years 2026 through 2030.''.
<all>