An Act amending Title 35 (Health and Safety) of the Pennsylvania Consolidated Statutes, establishing the Maternal Health Monitoring Pilot Program.

PRINTER'S NO. 1858
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1569
Session of
2025
INTRODUCED BY SHUSTERMAN, GIRAL, PROBST, PIELLI, HILL-EVANS,
K.HARRIS, CEPHAS, SANCHEZ, CURRY, HOHENSTEIN, BOROWSKI,
FLEMING AND RIVERA, JUNE 5, 2025
REFERRED TO COMMITTEE ON CHILDREN AND YOUTH, JUNE 9, 2025
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, establishing the Maternal Health
Monitoring Pilot Program.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Title 35 of the Pennsylvania Consolidated
Statutes is amended by adding a chapter to read:
CHAPTER 54A
MATERNAL HEALTH MONITORING PILOT PROGRAM
Sec.
54A01. Definitions.
54A02. Establishment of pilot program.
54A03. Administration of pilot program.
54A04. Remote patient monitoring for maternal hypertension and
maternal diabetes requirements.
54A05. Requirements for contracts with participating managed
care organizations.
54A06. Implementation of pilot program.
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54A07. Fee payment for administration of pilot program.
54A08. Operation of pilot program.
54A09. Report.
54A10. Expiration of authority.
§ 54A01. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Department." The Department of Health of the Commonwealth.
"Eligible participant." A patient who is:
(1) a recipient of medical assistance;
(2) a member of a participating managed care
organization; and
(3) pregnant.
"Health care provider." An obstetrician or maternal fetal
medicine physician who is:
(1) Licensed in this Commonwealth.
(2) In-network of a participating managed care
organization.
(3) Caring for an eligible participant during pregnancy.
"Nursing team." A group made up of health care providers
that can provide nutrition and diabetes management counseling
and advice.
"Participating managed care organization." The managed care
organizations selected by the department under section 54A03
(relating to administration of pilot program). Each
participating managed care organization shall:
(1) Contract directly with the selected vendor to offer
remote patient monitoring for maternal hypertension and
maternal diabetes to eligible participants.
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(2) Ensure that eligible patients have access to the
pilot program.
"Pilot program." The Maternal Health Monitoring Pilot
Program established under section 54A02 (relating to
establishment of pilot program).
"Remote patient monitoring for maternal hypertension and
maternal diabetes." Technology provided by the selected vendor
that:
(1) Collects health data from an eligible participant
and electronically transmits the information securely for
interpretation and recommendation.
(2) Uses a device that meets all of the following
criteria:
(i) The device is compliant with 42 U.S.C. Ch. 7
Subch. XI Pt. C (relating to administrative
simplification).
(ii) The device is authorized by the United States
Food and Drug Administration.
(3) Monitors health data, including blood pressure,
weight, blood glucose levels or other physiologic health data
as determined by the eligible participant's health care
provider.
(4) Is capable of transmitting health data through
cellular networks.
"Selected vendor." The technology vendor selected by the
department under section 54A03 to contract with the
participating managed care organizations in administering the
pilot program.
§ 54A02. Establishment of pilot program.
The Maternal Health Monitoring Pilot Program is established
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within the department to offer eligible participants improved
maternal health care through remote patient monitoring for
maternal hypertension and maternal diabetes.
§ 54A03. Administration of pilot program.
The department shall select one or more participating managed
care organizations and one technology vendor to administer the
pilot program in a manner determined by the department.
§ 54A04. Remote patient monitoring for maternal hypertension
and maternal diabetes requirements.
The participating managed care organizations shall meet the
following requirements when offering remote patient monitoring
for maternal hypertension and maternal diabetes to an eligible
participant under the pilot program:
(1) Ensure that remote patient monitoring for maternal
hypertension and maternal diabetes is possible during
pregnancy and for up to three months postpartum.
(2) Ensure that each health care provider and nursing
team providing care is licensed in this Commonwealth. The
health care provider and nursing team must be capable of the
following:
(i) Monitoring and reviewing eligible participants'
health data.
(ii) Creating an escalation pathway with the
participating managed care organization if an eligible
participant's remote patient monitoring readings, in
conjunction with the eligible participant's symptoms,
require additional medical attention.
(iii) Providing health coaching to eligible
participants, including nutrition, condition management
and healthy behavior modification.
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(iv) Supporting the eligible participant's health
care provider in monitoring and reviewing health data.
§ 54A05. Requirements for contracts with participating managed
care organizations.
The selected vendor shall meet the following requirements
when contracting with participating managed care organizations:
(1) Ensure that remote patient monitoring for maternal
hypertension and maternal diabetes devices are delivered to
the eligible participant.
(2) Ensure that the eligible participant is provided
training on how to use the remote patient monitoring for
maternal hypertension and maternal diabetes devices.
(3) Assign a program manager to support implementation
and administration of the pilot program and to coordinate
efforts with the participating managed care organizations and
the department.
§ 54A06. Implementation of pilot program.
The department shall implement the pilot program as necessary
to ensure participation of a statistically relevant number of
eligible participants. The participating managed care
organizations shall ensure that eligible participants have
access to the pilot program.
§ 54A07. Fee payment for administration of pilot program.
(a) Fee payment.--
(1) The department shall pay a fee to the participating
managed care organizations to administer the pilot program.
(2) The fee shall be determined by the department.
(b) Use of fee.--The participating managed care
organizations shall use the fee payment under subsection (a) to
cover the costs of the following:
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(1) Contracting with the selected vendor under section
54A03 (relating to administration of pilot program).
(2) Administering the pilot program.
§ 54A08. Operation of pilot program.
The pilot program shall be operational no later than 180 days
from the contract date between the participating managed care
organizations and the selected vendor under section 54A03
(relating to administration of pilot program).
§ 54A09. Report.
Within one year of the pilot program's implementation, the
department shall collaborate with the participating managed care
organizations and any other relevant stakeholders to develop a
report evaluating the outcomes of the pilot program, including
recommendations regarding whether the pilot program should be
expanded throughout this Commonwealth. The department shall
submit the report to all of the following:
(1) The Governor.
(2) The President pro tempore of the Senate.
(3) The Speaker of the House of Representatives.
(4) The chairperson and minority chairperson of the
Appropriations Committee of the Senate.
(5) The chairperson and minority chairperson of the
Appropriations Committee of the House of Representatives.
(6) The chairperson and minority chairperson of the
Health and Human Services Committee of the Senate.
(7) The chairperson and minority chairperson of the
Health Committee of the House of Representatives.
(8) The chairperson and minority chairperson of the
Human Services Committee of the House of Representatives.
§ 54A10. Expiration of authority.
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The department's authority to implement the pilot program
shall expire two years after the effective date of this section.
Section 2. This act shall take effect in 90 days.
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