CMS Introduces Policies to Lower Maternal Mortality, Expand Care Access, and Enhance Health Equity.

The Centers for Medicare & Medicaid Services (CMS) has unveiled new health and safety standards specifically designed for hospitals and Critical Access Hospitals (CAHs) that provide obstetrical services. This initiative aims to enhance the safety of care for expectant mothers during pregnancy, childbirth, and postpartum recovery, addressing the pressing maternity care crisis in the U.S. This announcement is part of the final rule for the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC).

Key Highlights of the Announcement:

  • New Maternal Health Standards:
    CMS is for the first time setting standards for maternal health and safety in hospitals. These standards will establish basic standards for staffing, organization, and care delivery in obstetrical care units. Further, CMS will revise the quality assessment and performance improvement (QAPI) program to address the need to meet these standards for all staff members; training on EB maternal health practices will also be implemented.
  • Payment Rate Increase:
    The final rule also addresses a net change in payment rates of 2.9% which is equivalent to $2.2 billion in hospitals in 2025 based on the previous year. This financial assistance is to help hospitals in providing quality healthcare services to their clients.
  • Expanded Access to Behavioral Health Services:
    The new regulations also address the expansion of access to behavioral health services and reductions in barriers to acquiring costly cancer treatment drugs, especially for tribes. CMS is adding new codes for more payment for non-opioid therapies and devices, a move the agency says is aimed at addressing the opioid epidemic and enhancing pain management.
  • Support for Formerly Incarcerated Individuals:
    To increase access to care for all those who have been previously incarcerated, CMS is eliminating Medicare work requirements for those on bail, parole, or probation. The special enrollment periods will be liberalized to help such persons as they are readjusted back into society.
  • Promoting Health Equity:
    CMS’s initiatives aim to address health disparities and improve access to care for underserved communities. Dr. Meena Seshamani, Deputy Administrator of CMS, emphasized that these new policies are designed to ensure that all patients, including those transitioning from incarceration, have access to critical services like pain management and cancer treatment.
  • Medicaid Service Expansions:
    The final rule will also improve Medicaid coverage by allowing states to provide clinic services outside traditional settings, including Indian Health Services (IHS) and tribal clinics. Furthermore, it requires a 12-month continuous eligibility period for children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP).

The recent announcements from CMS represent a significant step forward in enhancing maternal health and expanding access to healthcare across the United States. By implementing comprehensive standards for obstetrical care and focusing on the needs of underserved populations, CMS is committed to building a healthier future for all Americans.

 


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