[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 5262 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
2d Session
S. 5262
To address maternity care shortages and promote optimal maternity
outcomes by expanding access to birth centers and exploring more
effective payment models for birth center care, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 25, 2024
Mr. Lujan introduced the following bill; which was read twice and
referred to the Committee on Finance
_______________________________________________________________________
A BILL
To address maternity care shortages and promote optimal maternity
outcomes by expanding access to birth centers and exploring more
effective payment models for birth center 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 ``Better Availability of Birth Centers
Improves Outcomes and Expands Savings Act'' or the ``BABIES Act''.
SEC. 2. GRANTS TO IMPROVE ACCESS TO FREESTANDING BIRTH CENTER SERVICES.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399V-8. STRONG START BIRTH CENTER GRANTS TO ASSIST BIRTH CENTERS
WITH START-UP OR EXPANSION COSTS TO EXPAND ACCESS TO
BIRTH CENTER SERVICES IN UNDERSERVED AREAS.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, may award grants
to eligible birth centers that are accredited, or intend to seek
accreditation, as birth centers by a nationally recognized accrediting
body such as the Commission for the Accreditation of Birth Centers, or
that have the intention of seeking such accreditation, for the purposes
described in subsection (b).
``(b) Use of Funds.--A birth center receiving a grant under this
section may use such grant funds for any of the following purposes:
``(1) Renovation, expansion, or construction of a birth
center facility.
``(2) Purchasing or updating equipment for a birth center.
``(3) Accreditation and State licensure activities.
``(c) Grants; Grant Amounts.--For each of fiscal years 2025 through
2029, the Secretary shall award grants under this section to up to 15
birth centers, each in an amount of not less than $300,000 and not more
than $500,000.
``(d) Special Considerations.--In awarding grants under this
section, the Secretary shall give special consideration to an eligible
birth center that--
``(1) is located in, or offers services to, a geographic
area that--
``(A) has been designated under section 332 as a
health professional shortage area with respect to
maternity care; or
``(B) has maternity care outcomes that are below a
threshold established by the Secretary; and
``(2) has not previously received a grant under this
section.
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for the period of
fiscal years 2025 through 2029.''.
SEC. 3. MEDICAID DEMONSTRATION PROGRAM TO IMPROVE FREESTANDING BIRTH
CENTER SERVICES.
Section 1903 of the Social Security Act (42 U.S.C. 1396b) is
amended by adding at the end the following new subsection:
``(cc) Demonstration Program To Improve Freestanding Birth Center
Services.--
``(1) Authority.--The Secretary shall conduct a
demonstration program for the purpose of exploring more
effective payment models for birth center care in order to
improve access to, and the quality and scope of, freestanding
birth center services for women with a low-risk pregnancy who
are eligible for medical assistance under the State plan under
this title or under a waiver of such plan.
``(2) Deadlines for participation criteria, prospective
payment system; planning grants.--
``(A) Participation and prospective payment system
deadline.--Not later than 1 year after the date of the
enactment of this subsection, the Secretary shall do
the following:
``(i) Publication of participation criteria
for freestanding birth centers.--
``(I) In general.--The Secretary
shall publish criteria for a
freestanding birth center to be
certified by a State for purposes of
participating in a State demonstration
program conducted under this
subsection.
``(II) Requirements.--The criteria
required to be published under
subclause (I) shall include the
following:
``(aa) Accreditation.--At
the time of certification for
purposes of participating in
the demonstration program
conducted under this
subsection, a freestanding
birth center must be accredited
or have completed the initial
phase of accreditation from an
approved, nationally-recognized
birth center accreditation
body, as determined by the
Secretary.
``(bb) Licensure and other
requirements.--A freestanding
birth center shall--
``(AA) be licensed,
or otherwise approved,
by the State to provide
prenatal, labor and
delivery, postpartum,
newborn care, and other
ambulatory services for
which medical
assistance is available
under the State plan or
waiver under this
title; and
``(BB) comply with
such other requirements
relating to the health
and safety of
individuals who receive
services furnished by
the facility as the
State shall establish.
``(cc) Care coordination.--
A freestanding birth center
shall be able to meet care
coordination requirements
established by the Secretary,
including requirements to
coordinate care across settings
and providers to ensure
seamless transitions for
patients across the full
spectrum of health services,
and shall be able to engage in
consultation for higher level
maternity care services, non-
maternity care services, and
behavioral health needs, which
may include plans for
consultation, collaboration and
referral, and arrangements with
the following:
``(AA) Federally
qualified health
centers (and as
applicable, rural
health clinics) to
provide Federally
qualified health center
services (and as
applicable, rural
health clinic services)
to the extent such
services are not
provided directly
through the birth
center.
``(BB) Other
outpatient clinics,
including licensed
midwifery and physician
practices.
``(CC) Inpatient
acute care facilities
with obstetrical care
units.
``(dd) Scope of services.--
As determined by the Secretary,
a freestanding birth center
shall be able to provide
peripartum care for women with
a low-risk pregnancy and for
newborns, consistent with
evidence-based guidelines.
``(ee) Capabilities.--A
freestanding birth center shall
have the following
capabilities:
``(AA) In addition
to the requirements
specified under section
431.53 of title 42,
Code of Federal
Regulations, and any
successor regulation
(relating to assurance
of transportation), the
capability and
equipment to provide
prenatal, labor and
delivery, postpartum,
and newborn care for
women with a low-risk
pregnancy, readiness at
all times to initiate
emergency procedures to
meet unexpected needs
of such women and of
newborns within the
center, including at
least 2 qualified staff
on-site at every birth,
and the ability to
facilitate transport to
an acute care hospital
with an obstetrical
care unit when
necessary.
``(BB) An
established transfer
plan with a receiving
hospital with an
obstetrical care unit
with policies and
procedures for timely
transport.
``(CC) Medical
consultation available
from a licensed board-
certified physician
with admitting
privileges in
obstetrics at a nearby
hospital, as defined by
State law or
regulation.
``(DD) Data
collection, storage,
and retrieval,
including data on
intrapartum and
postpartum maternal and
newborn transfer rates
and hospital
admissions.
``(EE) The ability
to initiate and
document quality
improvement programs as
required by
accreditation that
include efforts to
maximize patient
safety, such as safety
checklists, validated
training and competency
of staff, and emergency
preparedness and
drills.
``(ff) Health care
providers.--A freestanding
birth center shall employ, or
have care delivery arrangements
with, both of the following:
``(AA) A physician
licensed to practice
within the State or
jurisdiction of the
birth center.
``(BB) A midwife
that meets or exceeds
the education and
training standards of
the International
Confederation of
Midwives and who is
licensed to practice
within the jurisdiction
of the birth center.
``(gg) Non-duplication.--In
carrying out this subsection,
the Secretary shall, with
respect to a State
participating in the
demonstration program,
establish procedures to
prevent, to the greatest extent
practicable, the provision of,
or payment for, services under
the demonstration program for
which medical assistance is
available under the State plan
under this title or waiver of
such plan.
``(ii) Guidance on development of
prospective payment system for testing under
state demonstration programs.--
``(I) In general.--The Secretary
shall issue guidance for States
participating in a demonstration
program conducted under this subsection
to establish a prospective payment
system that shall only apply to
freestanding birth center services
that--
``(aa) meet the criteria
established under clause (i);
and