Federal and Legislative Actions
Congress and the Biden administration have both taken significant steps toward reducing maternal mortality and morbidity.
In June, the White House released Blueprint for Addressing the Maternal Health Crisis, a whole-of-government approach to combatting maternal mortality and morbidity, which includes 50 commitments from more than a dozen federal agencies aimed at combatting maternal mortality and morbidity, ending maternal health disparities and improving the overall experience of pregnancy, birth and postpartum for people across the country. HIMSS was proud to support the Blueprint. The actions are centered around five key goals:
Increase Access to and Coverage of Comprehensive High-Quality Maternal Health Services, Including Behavioral Health Services
Ensure Those Giving Birth are Heard and are Decision makers in Accountable Systems of Care
Advance Data Collection, Standardization, Harmonization, Transparency, and Research
Expand and Diversify the Perinatal Workforce
Strengthen Economic and Social Supports for People Before, During, and After Pregnancy
To support the implementation of the Administration’s Blueprint, in July the Centers for Medicare and Medicaid Services (CMS) released their Maternity Care Action Plan which will take a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period. CMS has identified five key gaps in maternity care related to CMS programs: 1) coverage and access to care; 2) data; 3) quality of care; 4) workforce; and, 5) social supports.
On the Congressional front, provisions from two key HIMSS-endorsed bills were enacted as part of Consolidated Appropriations Act, 2022, the Rural Maternal and Obstetric Modernization of Services Act (Rural MOMS Act) H.R.769/S.1491 and the Maternal Health Quality Improvement Act, H.R.4387/S.1675. The FY22 omnibus bill also included nearly $1 in funding for maternal and child health programs to address maternal mortality and severe maternal morbidity, a 4 percent increase above the FY21 enacted level. Overall, the omnibus bill included the following digital health provisions:
- Directs various units within the U.S. Department of Health and Human Services to improve collection and research efforts related to rural and maternal obstetric care data
- Authorizes $3M for each of FY22-26 for HHS to award grants to establish rural obstetric networks for quality improvement and innovation.
- HRSA grants to identify, develop and disseminate best practices to improve maternal health care quality and outcomes
- Training for health care providers to improve prenatal, labor, birthing, and postpartum care for racial and ethnic minority populations, including with respect to preexisting perceptions and biases.
- Funding for Telehealth Network and Telehealth Resource Centers Grant Programs, authorizing the Telehealth Network Grant Program at HRSA to include providers of prenatal, labor care, birthing, and postpartum care services.
Black Maternal Health Momnibus Act of 2021
Additionally, there continues to be pressure to see the Black Maternal Health Momnibus Act of 2021 (H.R. 959/S. 346), known as the “Momnibus”, signed into law. The Momnibus is a comprehensive legislative package composed of 12 individual bills that address every dimension of this U.S. maternal health crisis and tackle long-standing health care disparities. The legislation proposes to strengthen federal maternal health programs like the CDC's Surveillance for Emerging Threats to Mothers and Babies program, Enhancing Reviews and Surveillance to Eliminate Maternal Mortality (ERASE MM), which supports maternal mortality review committees and Pregnancy Risk Assessment Monitoring System (PRAMS). It would make investments in SDOH, CBO’s, the growth and diversification of the perinatal workforce, improvements in data collection and quality measures, digital tools like telehealth, innovative payment models, and address climate change-related risks for moms and their babies.
On November 30, 2021, President Joe Biden signed the first standalone Momnibus bill, The Protecting Moms Who Served Act (P.L.117-69), which supports comprehensive GAO studyon maternal mortality and severe maternal morbidity among veterans, with a particular focus on racial and ethnic disparities in maternal health outcomes. Key digital health provisions includeInvesting $15 million in maternity care coordination programs at VA facilities to:
- Ensure effective coordination between VA facilities and non-VA facilities in the delivery of maternity care and other healthcare services;
- Facilitate access and referrals to resources in the community to address social determinants of health;
- Identify mental and behavioral health risk factors in the prenatal and postpartum periods, and ensure that pregnant and postpartum veterans get the help and treatment they need; and
- Make recommendations for the improvement of maternal health data collection processes
HIMSS and its maternal health partners continue to press for advancements in digital health for maternal health despite BBB breakdown. As the Public Health Emergency winds down or expires, greater emphasis is placed on advancing policies at state level and focusing on Medicaid strategies.
American Rescue Plan Act of 2021 gives states a new option to extend Medicaid postpartum coverage to 12 months via a state plan amendment (SPA). This new option takes effect on April 1, 2022 and is available to states for five years.