CMS for the first time has proposed "baseline" requirements related to hospitals' obstetrical services, which include standards related to staffing and emergency readiness.
On July 10, the agency announced new policies aimed at reducing maternal mortality and morbidity, including new requirements under the Outpatient Prospective Payment System proposed rule for 2025. The proposal introduces requirements for hospitals and critical access hospitals on maternal quality improvement efforts. These requirements include baseline standards around staffing, the delivery of obstetrical care, emergency services readiness, transfer protocols for obstetrical patients, and annual training on evidence-based maternal health practices, cultural competencies and other topics.
"CMS is using all of our tools to improve the safety, quality, and timeliness of the care that hospitals provide to pregnant women," Dora Hughes, MD, acting CMS chief medical officer and acting director of the agency's center for clinical standards and quality, said in a news release. "Through these proposals, we will ensure people get timely access to quality care in their communities, leading to improved outcomes and better health."
Additionally, CMS proposed a range of new policies under the hospital OPPS and ASC proposed rules to expand access to care and advance health equity. These include exceptions to the Medicaid clinic services "four walls" requirement, codifying the 12 months of continuous eligibility requirement for children on Medicaid and CHIP through the Consolidated Appropriations Act, and an add-on payment for certain Indian Health Services and tribal facilities to increase access to cancer services and others that use high-cost drugs.
For hospitals and ASCs that meet applicable reporting requirements, CMS has proposed a 2.6% OPPS rate increase in 2025.