II
119th CONGRESS
2d Session
S. 4482
IN THE SENATE OF THE UNITED STATES
May 11, 2026
Ms. Blunt Rochester introduced the following bill; which was read twice and referred to the Committee on Finance
A BILL
To amend title XVIII of the Social Security Act to require hospitals to develop discharge plans for pregnant individuals as a condition of participation under Medicare, and for other purposes.
Short title
This Act may be cited as the Women Expansion of Learning and Labor Safety Act
or the WELLS Act
.
Requiring hospitals participating in Medicare to develop discharge plans for pregnant individuals
Section 1866 of the Social Security Act (42 U.S.C. 1395cc) is amended—
in subsection (a)(1)—
in subparagraph (X), by striking and
at the end;
in subparagraph (Y), by striking the period at the end and inserting , and
; and
by adding at the end the following new subparagraph:
beginning January 1, 2027, in the case of a hospital, critical access hospital, or rural emergency hospital, to comply with the requirements described in subsection (l)(1).
; and
by adding at the end the following new subsection:
Discharge plan requirements for pregnant individuals
In general
For purposes of subsection (a)(1)(Z), the requirements described in this paragraph are, with respect to a hospital, critical access hospital, or rural emergency hospital, that the hospital—
provides for the development and implementation of a discharge plan meeting the standards under paragraph (2) with respect to any individual (whether or not eligible for benefits under this title) admitted to the hospital who—
is pregnant;
is experiencing signs or symptoms consistent with labor, which may include contractions; and
is expected to be discharged from the hospital, critical access hospital, or rural emergency hospital prior to delivery, as determined based on the documented clinical judgment of the treating physician or practitioner at the time that such discharge is contemplated;
includes such discharge plan in the individual’s medical record; and
provides for such discharge plan to be discussed with the individual (or the individual’s representative) prior to discharge.
Discharge plan standards
A discharge plan for an individual described in paragraph (1)(A) meets the standards under this paragraph if such plan includes at least the following information:
A clinical justification for the discharge.
An assessment of travel distance and time between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.
Verification of reliable transportation between the primary residence of the individual and the hospital, critical access hospital, or rural emergency hospital.
Identification of a secondary hospital or facility at which such individual may obtain labor and delivery services.
Confirmation that the plan was reviewed and approved by a registered professional nurse, social worker, or other appropriately qualified personnel.
Confirmation that the individual (or the individual’s representative) has received the information described in subparagraphs (A) through (D), that such information was provided in the primary language of such individual (or representative), and that such individual (or representative) confirmed their understanding of such information.
Rule of construction
Nothing in this subsection shall be construed as limiting or otherwise affecting the discharge planning requirements otherwise applicable to a hospital, critical access hospital, or rural emergency hospital under this title, or any obligation of a health care provider to furnish emergency services as required under State or Federal law, including section 1867 of this title (commonly known as the Emergency Medical Treatment and Labor Act
).
.
Rural maternal and obstetric care training demonstration grants
Section 764 of the Public Health Service Act (42 U.S.C. 294s) is amended—
by redesignating subsections (d) and (e) as subsections (e) and (f), respectively;
by inserting after subsection (c) the following:
Minimum performance milestones
Establishment
Beginning with the grants awarded under this section for fiscal year 2027, the Secretary shall establish minimum performance milestones that grant recipients must meet during a fiscal year as a condition of remaining eligible for funding through such a grant for any subsequent fiscal year.
Milestones related to percent of staff trained
The minimum performance milestones referred to in paragraph (1) shall include milestones related to the percent of all staff of the grant recipient that are trained, or that receive refresher training, with support from a grant under this section.
; and
in subsection (e), as so redesignated—
in the subsection heading, by striking report
and inserting reports
;
in paragraph (1)(B), by striking the report described in paragraph (2)
and inserting the reports described in paragraphs (2) and (3)
; and
by adding at the end the following:
Subsequent reports
Not later than January 1, 2027, and annually thereafter, the Secretary shall submit to Congress, and make publicly available, a report that includes—
updates to the information described in subparagraphs (A) through (C) of paragraph (2); and
additional information regarding the grants under this section, including—
a list of the entities receiving such grants;
the number and amount of such grants;
whether training supported by such grants was delivered in-person, virtually, asynchronously, or through some other format; and
descriptions of the geographical coverage of such grants, the number of providers trained under such grants, and patient-level metrics linked to such training (such as changes in clinical outcomes, patient experience, and racial disparities).
.
Multi-center implementation science initiative for maternal health
Establishment
The Secretary of Health and Human Services, in consultation with the Director of the Agency for Healthcare Research and Quality and the Director of the National Institutes of Health (in this section referred to as the Secretary
) shall establish a multi-center implementation science initiative for maternal health to rigorously evaluate different training models for health care professionals (including in-person, virtual, simulation, and cohort-based) and the impact of such models on provider behavior, patient outcomes, and maternal health disparities.
Interagency maternal health dashboard
As part of the initiative described in subsection (a), the Secretary shall develop, maintain, and make publicly available on the website of the Department of Health and Human Services an interagency maternal health dashboard, which shall include maternal health outcome metrics from agencies within the Department of Health and Human Services.