Maternal Health Monitoring Pilot Program; established, report.

SENATE BILL NO. 721

AMENDMENT IN THE NATURE OF A SUBSTITUTE

(Proposed by the Senate Committee on Education and Health

on February 5, 2026)

(Patron Prior to Substitute--Senator Carroll Foy)

A BILL to amend the Code of Virginia by adding in Chapter 10 of Title 32.1 an article numbered 5, consisting of sections numbered
32.1-331.18
through
32.1-331.24
, relating to Maternal Health Monitoring Pilot Program established; report.

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia is amended by adding in Chapter 10 of Title 32.1 an article numbered 5, consisting of sections numbered
32.1-331.18
through
32.1-331.24
, as follows:

Article
5
.

Maternal Health Monitoring Pilot Program
.

§ 32.1-
331.18
. Definitions.

As used in this article, unless the context requires a different meaning:

"Depar
tment" means the Department of Medical Assistance Services.

"Eligible participant" means a patient who is (i) a recipient of medical assistance services
,
(ii) a member of the participating managed care organization
,
and
(iii) pregnant.

"Escalation pathway" means an agreement between the participating managed care organizations and the technology vendor on a process to follow when an eligible participant's
medical indicators
are concerning and warrant further review and investigation.

"Health care provider" means an obstetrician or maternal fetal medicine physician who is licensed in the Commonwealth and caring for an eligible patient during pregnancy.

"Participating managed care organization" means the managed care organization selected by the Department to administer the
P
ilot
P
rogram.

"Pilot
P
rogram" means the Maternal Health Monitoring Pilot Program
established
pursuant to
this article
.

"Remote monitoring clinical care team" means a team
co
nsisting
of nurses licensed in the Commonwealth, dietitians, and certified diabetes care and education specialists that monitor eligible participants'
medical indicators
and
provide nutrition
guidance, diabetes and hypertension management counseling, and pregnancy and postpartum advice.

"
Technology vendor" means the technology company selected by the Department to contract with the participating managed care organization in administering the
P
ilot
P
rogram
.

§ 32.1-
331.19
. Establishment
and administration
of
Maternal Health Monitoring Pilot Program.

A.
For fiscal years 2027 and 2028, the
Maternal Health Monitoring P
ilot
P
rogram is established within the Department to offer eligible participants improved maternal health care through remote patient monitoring for maternal hypertension and maternal diabetes.

B.
The Department shall select
one or more
managed care organization
s
and
one

technology vendor to administer the
P
ilot
P
rogram
in a manner determined by the Department. For the purpose of administering the

P
ilot
P
rogram
, the participating managed care organization
s
shall contract directly with
the
technology vendor to offer remote patient monitoring for maternal hypertension and maternal diabetes
and ensure that eligible participants have access to th
e
P
ilot
P
rogram
.

§ 32.1-
331.20
. Remote patient monitoring for maternal hypertension and maternal diabetes.

A. Technology for remote patient monitoring for maternal hypertension and maternal diabetes provided by the technology vendor shall:

1. Collect health data from an eligible participant and electronically
transmit

that information securely for interpretation by a health care provider;

2. Be authorized by the U
.
S
.
Food and Drug Administration;

3. Monitor health data, including blood pressure, weight, blood glucose levels, or other physiological health data
as determined by the eligible participant's health care provider;

4. Be capable of transmitting health data through cellular networks
;
and

5. Be pre-programmed specifically for each eligible participant so that it works directly out-of-the-box for that specific eligible participant.

B. The technology vendor shall
ensure that
:

1.
R
emote patient monitoring for maternal hypertension and maternal diabetes is possible
during pregnancy and
for up to three months postpartum;

2. Remote patient monitoring devices are
provided and
delivered to
each
eligible participant;
and

3. The eligible participant has a process to be trained on use of the remote patient monitoring devices.

C. The technology vendor shall
ensure that the remote monitoring clinical care team
is

capable of:

1. Monitoring and reviewing eligible participants' health data;

2. Creating an escalation pathway with an eligible participant's
participating managed care organization and
health care provider if the eligible participant's remote patient monitoring readings, in conjunction with the eligible participant's symptoms, require immediate attention from the eligible participant's health care provider as determined by clinical practice guidelines;

3. Providing health coaching to participants, including nutrition, condition management, and healthy behavior modification
; and

4. Coordinating with the elig
ible participant's health care provider as needed.

§ 32.1-
331.21
. Eligible
localities
.

The Department shall implement the
P
ilot
P
rogram
in as many
localities
as necessary to ensure participation of
up to 500
eligible participants. The participating managed care organization shall ensure that eligible participants in the
localities
selected by the Department have access to the
P
ilot
P
rogram
.

§ 32.1-
331.22
. Fee payment for administration of
P
ilot
P
rogram
.

A. The Department shall pay a fee
of no more than $500,000
to participating managed care organization
s
to administer the
P
ilot
P
rogram
.

B. The participating managed care organization shall use the fee paid pursuant to subsection A to cover the costs of
c
ontracting with the technology vendor
and a
dministrating the
P
ilot
P
rogram
.

§ 32.1-
331.23
. Operation of
P
ilot
P
rogram
.

The Department shall ensure that the
P
ilot
P
rogram
has
up to 500
eligible participants. The
P
ilot
P
rogram
shall be operational no later than 180 days after the contract date between the participating managed care organization and the technology vendor.

§ 32.1-
331.24
. Report.

A.
No later than 18 months after the first eligible participant is enrolled in the
P
ilot
P
rogram
, the Department shall
collaborate
with participating managed care organizations and other relevant stakeholders to develop a report evaluating the outcomes of the Pilot Program
,
including recommendations regarding whether the
P
ilot
P
rogram
should be expanded throughout the
Commonwealth.

B. The report shall evaluate claims data, vital stats data,
and E
H
R/EMR data
of participants
to determine the Pilot Program's impact on the following maternal, fetal, and neonatal health outcomes and evaluate whether the Pilot Program improves
those outcomes while reducing Medicaid costs:

1. Maternal outcomes:

a. Maternal mortality rate;

b. Severe maternal morbidity rate;

c. Preeclampsia;

d. C-section rate;

e. Mean length of hospital stay;

f. ICU admission rate;

g.
Mean length of ICU stay;
and

h. Postpartum hospital readmission rate.

2. Fetal and neonatal outcomes:

a. Fetal mortality rate;

b. Fetal growth restriction;

c. Neonatal mortality rate;

d. NICU admission rate;

e. Mean length of NICU stay;

f. Neonatal hypoglycemia;

g. Preterm birth rate;

h. Gestational age at delivery;
and

i. Birthweight.

C.
The Department shall submit the report to:

1. The Governor;

2. The Chair of the Senate Committee on Finance and Appropriations;

3. The Chair of the House Committee on Appropriations;

4. The Chair of the Senate
Committee on
Education and Health; and

5. The Chair of the House Committee on Health and Human Services.