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Bill

HR 9061

PREEMPT Act

119th Congress Introduced by Yvette Clarke and 3 co-sponsors

Provides federal guidance and optional technical help to states on Medicaid/CHIP coverage of preeclampsia screening and biomarker tests to improve early detection.

Introduced in House
0
WeVote Research Nonpartisan
Bill Summary · HR 9061

Overview

  • Bill: H.R. 9061 (PREEMPT Act)
  • Session: 119th Congress, 2nd Session
  • Intent: Amend title XIX of the Social Security Act to require the Secretary of Health and Human Services to issue guidance to States on Medicaid/CHIP coverage for preeclampsia screening and early detection tests, including consideration of biomarker tests and related technical assistance.

Main Purpose and Intent

  • Establish a federal framework to guide States on which preeclampsia screening and early detection tests may be covered under Medicaid and the Children's Health Insurance Program (CHIP).
  • Emphasize using evidence-based, personalized, and biomarker-informed testing to improve maternal and fetal outcomes related to preeclampsia.
  • Provide technical assistance to States to determine coverage for specific tests, while preserving State flexibility and not creating a federal mandate to cover any particular test.

Key Provisions

  • Section 1949 (new) – Guidance and Technical Assistance on Coverage for Preeclampsia Tests:
    • (a) Guidance:
    • Due within 180 days after enactment.
    • Requires guidance to States and, where appropriate, Medicaid managed care organizations, on:
      • Best practices to improve outcomes for pregnant individuals eligible for Medicaid/State CHIP during screening, detection, and management.
      • Which tests for early detection may be furnished as medical assistance, including whether specific biomarker tests may be covered.
    • (b) Technical Assistance:
    • State requests for technical assistance must be addressed within 30 days.
    • Assures that providing technical assistance is not a condition for a State to cover a test or receive Federal financial participation.
    • (c) Biomarker Tests to be Considered:
    • The Secretary should consider advanced biomarker tests for early detection, including tests regulated and cleared as medical devices by the FDA, as well as laboratory-developed testing services conducted by certified high-complexity labs (under CLIA and PHS Act provisions).

Who Would Be Affected

  • State Medicaid programs, State Child Health Plans (CHIP), and Medicaid managed care organizations.
  • Pregnant individuals eligible for Medicaid/CHIP who may undergo preeclampsia screening and detection testing.
  • Federal and state public health program administrators responsible for coverage decisions and reimbursement policies.

Findings and Context (Findings Section)

  • Highlights the burden of preeclampsia:
    • Global and U.S. impact on maternal and fetal health.
    • Racial disparities (e.g., higher mortality among Black women).
    • Prevalence among leading causes of maternal morbidity and mortality.
    • Economic cost exceeding $2 billion annually in the U.S.
    • Association with preterm birth and long-term cardiovascular risk.
  • These findings provide the rationale for expanding guidance on coverage of screening and biomarker testing.

Procedural and Timeline Aspects

  • Enactment steps:
    • Requires the Secretary to issue guidance within 180 days of enactment.
    • Requires Secretary to provide technical assistance to States within 30 days of a request.
  • No mandate requiring States to cover a specific test; guidance and assistance are intended to inform and facilitate coverage decisions.

Potential Impact

  • Harmonization and clarity for States on coverage scope for preeclampsia testing under Medicaid/CHIP.
  • Encouragement of use of evidence-based and biomarker-driven approaches to early detection and management.
  • Potentially expanded access to advanced screening tools for pregnant individuals, particularly in states that adopt the guidance.
  • May influence payer policies, lab testing practices, and subsequent maternal health outcomes by prioritizing effective screening and early intervention.

Note: The bill is at the introductory stage and would require passage by both chambers and the President to become law.

Compiled from official sources — confirm details with the bill’s official record.

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