Blood Pressure MATTERS Act

The bill would create a uniform, cross-program requirement that Medicaid, the Children’s Health Insurance Program, group health plans, ERISA plans, and the Internal Revenue Code cover validated home blood pressure devices used during pregnancy and for 12 months after the last day of pregnancy. It would set device rules that require FDA 510(k) clearance and listing on the American Medical Association validated device list and apply 120 days after enactment, with limited state transition relief.

• Pregnant and postpartum individuals and families: Would gain access to a validated home blood pressure device during pregnancy and for 12 months postpartum. Coverage would not require a hypertensive disorder diagnosis and would generally limit one device per two years.
• Medicaid and CHIP enrollees and states: Would have SBPM added to the Medicaid benefit baseline and included in CHIP pregnancy-related assistance. Medicaid would prohibit cost sharing for these devices and states get short legislative transition relief.
• Employers, insurers, and ERISA plans: Would have to cover the same specified devices under a new public health standard. The rule applies to plan years and items furnished on or after 120 days after enactment.