This bill would direct the Administrator of the Centers for Medicare & Medicaid Services to run a Perinatal Care Alternative Payment Model Demonstration Project from fiscal years 2027 through 2031. The project would let States test alternative payment models under Medicaid (title XIX) and the Children’s Health Insurance Program (title XXI) for maternity care for pregnant and postpartum enrollees. The Secretary must work with State Medicaid programs, maternity care providers, patient and community organizations, perinatal health workers, hospitals and birth centers, researchers, and other stakeholders. The bill lists what models should consider, including risk-based payment adjustments, evidence-based quality metrics, nonhospital birth settings, social determinants of maternal health, diverse maternity care teams (including doulas and certain lactation consultants), maternal mental health, and substance use disorders. The Secretary must evaluate effects on maternal health outcomes (with data broken down by race, ethnicity, language, income, geography, insurance type, and other factors), State maternity spending, and patient experience. The Secretary must report results and recommend whether to continue and expand the project within one year after the project ends or is terminated. The bill defines terms such as perinatal, postpartum (1 year after pregnancy), maternal mortality, severe maternal morbidity, maternity care provider, and perinatal health worker. The bill authorizes "such sums as are necessary" to carry out the project.
If you are pregnant or within one year after pregnancy and enrolled in Medicaid or CHIP, your State could choose to join this demonstration starting in fiscal year 2027. If your State participates, payment methods and how care is organized could change for maternity services in your State. Models could support care in nonhospital settings, use diverse care teams that may include doulas and lactation consultants, and consider social needs and mental health. The project would test different payment approaches and measure outcomes and experiences; it does not itself guarantee any specific new benefit or service.
The bill does not state specific dollar amounts. It authorizes "such sums as are necessary" to run the demonstration from FY2027 through FY2031. No cost estimate or specific appropriation figures are included in the bill text.
Supporters included in the bill text say the project would allow States to test new payment models aimed at improving maternal health outcomes and reducing disparities. The bill emphasizes measuring outcomes by race, ethnicity, language, income, and geography, and the inclusion of community-based workers and diverse care teams. It also requires evaluation and a report to Congress to inform whether the project should be continued and expanded.
No publicly available information.