S.F. 11 Section 1. MATERNAL HEALTH CARE COVERAGE FOR LOW-INCOME 1 WOMEN. 2 1. a. The department of human services, in cooperation 3 with the division of insurance of the department of commerce, 4 shall design a system that facilitates, seamlessly and with 5 continuity for low-income women who qualify for Medicaid 6 under the pregnancy-related coverage group, the transition to 7 comprehensive public or private health care coverage in the 8 postpartum period and beyond. The department and the division 9 shall cooperate to provide such women with information about 10 and assistance with enrollment in the most appropriate coverage 11 option. 12 b. The system shall include a process for a birthing 13 hospital as defined in section 135.131 or an attending 14 health care provider as defined in section 136A.2 to notify 15 the department of human services following the birth of a 16 child whose mother has pregnancy-related Medicaid coverage. 17 Following notification of the department by the birthing 18 hospital or attending health care provider, or, in the absence 19 of such notification, on the first day of the month following 20 the projected birth month of the child, the department shall 21 notify the woman who has pregnancy-related Medicaid coverage 22 that following the birth of the child she will be assigned to 23 the postpartum coverage group and that her coverage will end 24 sixty days postpartum. The notice shall also inform the woman 25 of the public and private health care coverage options for 26 which the woman may be eligible, and that the department will 27 assist in enrolling the woman in the most appropriate coverage. 28 The process shall ensure that any continued health care 29 coverage includes coverage of comprehensive maternal health 30 services including but not limited to screening and treatment 31 for postpartum depression and chronic conditions prevalent in 32 women of child-bearing age. 33 2. The department of human services shall collaborate 34 with Medicaid managed care organizations and Medicaid 35 -1- LSB 1073XS (3) 87 pf/nh 1/ 4

S.F. 11 providers including maternal and child health centers and 1 other appropriate entities, to ensure that low-income women of 2 child-bearing age are aware of health care coverage options and 3 the need for health care coverage and care before, during, and 4 after a pregnancy. The department shall incorporate into any 5 managed care organization contract a provision requiring the 6 offering of incentives to recipients to comply with prenatal 7 and postpartum care standards and requiring managed care 8 organizations to provide prenatal and postpartum care managers. 9 3. The department of human services shall collaborate with 10 the department of public health to coordinate their respective 11 programs in providing comprehensive maternal health services. 12 The department of public health shall incorporate into any 13 maternal health program, including but not limited to healthy 14 opportunities for parents to experience hope and the healthy 15 families Iowa program, information regarding options for 16 public and private health care coverage for low-income women 17 of child-bearing age. The department of human services and 18 the department of public health shall utilize Medicaid program 19 data, vital records data, and public health survey data to 20 identify gaps in health care coverage, monitor outcomes, and 21 inform policy to ensure the availability of comprehensive 22 maternal health care coverage and care for low-income women of 23 child-bearing age in the state. 24 EXPLANATION 25 The inclusion of this explanation does not constitute agreement with 26 the explanation’s substance by the members of the general assembly. 27 This bill relates to maternal health care coverage for 28 low-income women. 29 The bill directs the department of human services (DHS), in 30 cooperation with the division of insurance of the department 31 of commerce, to design a system that facilitates, seamlessly 32 and with continuity for low-income women who qualify for 33 Medicaid under the pregnancy-related coverage group, the 34 transition to comprehensive public or private health care 35 -2- LSB 1073XS (3) 87 pf/nh 2/ 4

S.F. 11 coverage during the postpartum period and beyond. DHS and the 1 division of insurance are to cooperate to provide such women 2 with information about and assistance with enrollment in the 3 most appropriate coverage option. 4 The system developed by DHS is also to include a process 5 for a birthing hospital or an attending health care provider 6 to notify DHS following the birth of a child whose mother 7 has pregnancy-related Medicaid coverage. Following such 8 notification or, in the absence of such notification, on the 9 first day of the month following the projected birth month 10 of the child, DHS is required to notify the woman who has 11 pregnancy-related Medicaid coverage that following the birth of 12 the child the woman will be assigned to the postpartum coverage 13 group and that coverage will end 60 days postpartum. The 14 notice is also required to inform the woman of the public and 15 private health care coverage options for which the woman may 16 be eligible, and that DHS will assist in enrolling the woman 17 in the most appropriate health care coverage. The process 18 shall ensure that any continued health care coverage includes 19 coverage of comprehensive maternal health services including 20 but not limited to screening and treatment for postpartum 21 depression and chronic conditions prevalent in women of 22 child-bearing age. 23 The bill also requires DHS to collaborate with Medicaid 24 managed care organizations and Medicaid providers including 25 maternal and child health centers and other appropriate 26 entities to ensure that low-income women of child-bearing 27 age are aware of health care coverage options and the need 28 for health care coverage and care before, during, and after 29 a pregnancy. The department shall incorporate into any 30 managed care organization contract a provision requiring the 31 offering of incentives to encourage compliance of recipients 32 with prenatal and postpartum care standards and requiring the 33 managed care organizations to provide prenatal and postpartum 34 care managers. 35 -3- LSB 1073XS (3) 87 pf/nh 3/ 4

S.F. 11 The bill requires DHS to collaborate with the department of 1 public health (DPH) to coordinate their respective programs 2 in providing comprehensive maternal health services. DPH is 3 required to incorporate into any maternal health program, 4 including but not limited to healthy opportunities for parents 5 to experience hope and the healthy families Iowa program, 6 information regarding options for public and private health 7 care coverage for low-income women of child-bearing age. 8 DHS and DPH are required to utilize Medicaid program data, 9 vital records data, and public health survey data to identify 10 gaps in maternal health care coverage, monitor outcomes, and 11 inform policy to ensure the availability of comprehensive 12 maternal health care coverage and care for low-income women of 13 child-bearing age in the state. 14 -4- LSB 1073XS (3) 87 pf/nh 4/ 4