H.R. 9816 — MOMMIES Act

This section extends continuous Medicaid and CHIP eligibility for pregnant and postpartum individuals to 1 year after the end of pregnancy (from 60 days), or longer at state option. It requires states to provide full-scope benefits during pregnancy and the postpartum period that are equivalent in amount, duration, and scope to those available to individuals described in section 1902(a)(10)(A)(i). It also requires Medicaid coverage of oral health services for pregnant and postpartum individuals, including at minimum preventive, diagnostic, periodontal, and restorative care consistent with American Academy of Pediatric Dentistry and American College of Obstetricians and Gynecologists recommendations.

This section establishes a maternity care home demonstration project under which the Secretary provides grants to at least 10 states, not later than 1 year after enactment, to implement or expand maternity care home models serving pregnant and postpartum individuals enrolled in Medicaid or CHIP. Eligible entities include freestanding birth centers, FQHCs, rural health clinics, and tribal health facilities; the project requires consultation with specified stakeholders and targets improvements in maternal and infant outcomes, birth equity, care coordination, and reductions in morbidity, mortality, cesarean rates, and disparities.

This section reapplies the Medicare payment rate floor to primary care services furnished under Medicaid, requiring states to pay at least 100 percent of the applicable Medicare rate (or higher at the Secretary’s discretion by up to 25 percent in rural areas, health professional shortage areas, or medically underserved areas) for services provided by physicians with primary specialties in family medicine, general internal medicine, pediatrics, or obstetrics and gynecology, advanced practice clinicians, rural health clinics, federally qualified health centers, title X health centers, and midwives, beginning the first month after enactment and excluding emergency department services. It also requires Medicaid managed care contracts to ensure equivalent payments to these providers.

This section requires the Medicaid and CHIP Payment and Access Commission to publish a report within one year on doula services coverage under State Medicaid programs, including current offerings by type, credentialing requirements, enrollment and payment data, barriers to coverage, strategies to recruit and sustain a diverse workforce, and recommendations for legislative and administrative actions to increase access. It directs the Centers for Medicare & Medicaid Services to issue guidance to States within one year after the report on coverage options, reimbursement levels sufficient for a living wage, and best practices for expanding access.

This section directs the Comptroller General to submit a report to Congress within one year on State Medicaid programs' use of telehealth to increase access to maternity care. The report must cover the number of states using such telehealth, common program characteristics and differences in approaches and maternal health outcomes, demographic and health outcome comparisons with in-person care, services and equipment provided, quality and patient satisfaction, spending and access impacts, barriers during the COVID-19 pandemic, and recommendations for legislative and administrative actions.