Expanding models to be tested by Center for Medicare and Medicaid Innovation to explicitly include maternity care and children’s health models

Section 1115A(b)(2) of the Social Security Act (42 U.S.C. 1315a(b)(2)), as amended by section 5209(b), is amended— (1) in subparagraph (B), by adding at the end the following: (xxix) Promoting evidence-based models of care that have been associated with reductions in pregnancy-related and infant health inequities, including incorporating the use of and payment for doulas, particularly community-based doulas, and promoting support for people during pregnancy and for the one-year period after the last day of such person’s pregnancy, through evidence-based models of antepartum, birth, postpartum care, and two-generation birthing person and newborn care models, and supporting the risk-appropriate use of out-of-hospital birth models, including births at home and in freestanding birth centers. Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section.; (2) in subparagraph (C), by adding at the end the following: (ix) Whether the model includes a regular process for ensuring the provision of culturally and linguistically appropriate services. (x) Whether health care services and supportive services included in the model are tailored to community health and health-related social needs and provided by community-based and community-led providers. (xi) Whether the model is designed to mitigate harmful effects of discrimination on the basis of race, sex, disability, ethnicity, language, and age.; and (3) by adding at the end the following: (D) Mandatory health equity models to be tested The Secretary shall select— (i) Medicaid payment models for culturally and linguistically appropriate antepartum, labor and delivery, and postpartum doula services, including community-based doula services, that are— (I) structured to provide payment to doulas as individuals, health care entity staff, or members of a doula group or collective, or through a third-party administrator; (II) designed to reduce racial and intersecting health inequities; (III) designed to provide doulas providing support with an equitable and sustainable reimbursement rate; (IV) designed to reduce barriers to workforce entry for culturally and linguistically competent and racially congruent doulas to provide services to Medicaid enrollees; and (V) designed with input from community-based doulas, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries; (ii) a Medicaid episode-based payment model for pregnancy-related services, including health care services and supportive services to address health-related social needs, during the prenatal, intrapartum, and postpartum periods, to improve health outcomes and reduce racial health inequities, and to be designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries; (iii) a Medicaid alternative payment model for a pregnancy-related health home service to improve health outcomes during and for one year after pregnancy and during the newborn period, and to reduce racial health inequities, designed with input from maternity care providers, maternal health advocates, reproductive justice advocates, and Medicaid beneficiaries; (iv) a Medicaid perinatal health worker service delivery model for culturally and linguistically appropriate and respectful health care and supportive services that are tailored to community health and health-related social needs, designed to improve health outcomes and mitigate harmful effects of racism and other forms of discrimination, and provided by community-based and community-led providers; and (v) one or more models exclusively focused on early intervention and prevention for children enrolled in a State plan (or waiver of such plan) under title XIX or a State child health plan under title XXI using evidence-based interventions including parenting support programs, home-visiting services, and dyadic therapy treatment for children and adolescents at risk. Such models shall be selected and evaluated based on their impact on quality, equity, and developmental outcomes, notwithstanding any other provision of this section..