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

PRINTER'S NO. 1105
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 965
Session of
2025
INTRODUCED BY CAPPELLETTI, COLLETT, SCHWANK, CULVER, BROWN,
SANTARSIERO, COSTA, KANE, HAYWOOD, L. WILLIAMS, TARTAGLIONE
AND BAKER, AUGUST 13, 2025
REFERRED TO HEALTH AND HUMAN SERVICES, AUGUST 13, 2025
AN ACT
Amending Title 35 (Health and Safety) of the Pennsylvania
Consolidated Statutes, providing for 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. Duties of each managed care organization.
54A06. Implementation of program in counties.
54A07. Fee payment for administration of pilot program.
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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:
"Clinical team." A group made up of nurses and dietitians
who:
(1) Monitor eligible participants' measurements.
(2) Provide nutrition guidance.
(3) Provide diabetes and hypertension condition
management counseling.
(4) Provide pregnancy and postpartum advice.
"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.
"Escalation pathway." An agreement between the participating
managed care organizations and the selected vendor on a process
to follow when an eligible participant's measurements are
concerning and warrant further review and investigation.
"Health care provider." An obstetrician or maternal fetal
medicine physician who:
(1) is licensed in this Commonwealth;
(2) is in-network of the participating managed care
organization; and
(3) is caring for an eligible participant during
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pregnancy.
"Maternity care desert." An area that does not have any of
the following:
(1) A hospital providing obstetric care.
(2) A birth center.
(3) An obstetrician gynecologist.
(4) A certified nurse midwife.
"Participating managed care organizations." The managed care
organizations selected by the department under section 54A03
(relating to administration of 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 meets all of the following criteria:
(1) The technology collects health data from an eligible
participant and electronically transmits that information
securely for interpretation and recommendation.
(2) The technology 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) The technology 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.
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(4) The technology is capable of transmitting health
data through cellular networks.
(5) The technology is preprogrammed, specific to each
participant and functions directly out of the box for the
participant.
"Selected vendor." The technology company selected by the
department to contract with the participating managed care
organizations in administering the pilot program.
"Technology." Cellular connected devices that deliver remote
patient monitoring for maternal hypertension and maternal
diabetes such as blood pressure monitors, blood glucose meters
and scales.
§ 54A02. Establishment of pilot program.
For fiscal years 2026-2027 and 2027-2028, the Maternal Health
Monitoring Pilot Program is established 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 managed care
organizations and one selected 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 selected vendor 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
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pregnancy and for up to three months postpartum.
(2) Ensure that remote patient monitoring devices are
delivered to the eligible participant.
(3) Ensure that the eligible participant has a process
to be trained on how to use the remote patient monitoring
devices.
(4) Employ a clinical team that is capable of the
following:
(i) Monitoring and reviewing participants' health
data.
(ii) Creating an escalation pathway with the
participating managed care organizations if the eligible
participant's remote patient monitoring readings, in
conjunction with the eligible participant's symptoms,
require additional medical attention.
(iii) Providing health coaching to participants,
including nutrition, condition management and healthy
behavior modification.
(5) Assign a program manager to support implementation
and administration of the pilot program and to coordinate
efforts with the participating managed care organizations and
department.
§ 54A05. Duties of each managed care organization.
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.
(2) Ensure that eligible patients have access to the
pilot program.
§ 54A06. Implementation of program in counties.
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The department shall implement the pilot program in as many
counties as necessary to ensure participation of no more than
300 eligible participants. The following shall apply:
(1) The department shall implement the pilot program in
at least one county with a maternity care desert.
(2) The department shall implement the pilot program in
at least one rural county, as defined by the Center for Rural
Pennsylvania.
§ 54A07. Fee payment for administration of pilot program.
(a) Fee payment.--The department shall pay a fee, totaling
no more than $600,000 in the aggregate, to the participating
managed care organizations to administer the pilot program.
(b) Use of fee.--The participating managed care organization
shall use the fee payment under subsection (a) to cover the
costs of the following:
(1) contracting with the selected vendor under section
54A03 (relating to administration of pilot program); and
(2) administering the pilot program.
§ 54A08. Operation of pilot program.
(a) Number of participants.--The department shall ensure
that the pilot program has no more than 300 eligible
participants.
(b) Date of operation.--The pilot program shall be
operational no later than 180 days after the contract date
between the participating managed care organizations and the
selected vendor under section 54A03 (relating to administration
of pilot program).
§ 54A09. Report.
No later than 24 months after the expiration of the pilot
program, the department shall collaborate with the participating
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managed care organizations and any other relevant stakeholders
to develop a report evaluating the outcomes of the pilot
program, including cost savings, impact on morbidity rates and
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.
The department's authority to implement the pilot program
shall expire two years after the date that the pilot program is
operational.
Section 2. This act shall take effect in 60 days.
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