Hospitals and physicians are voicing concerns over the Biden administration's proposed rules to improve maternal health, arguing the current approach is too punitive and could inadvertently hinder access to obstetrical care.
On July 10, CMS proposed "baseline" obstetrical service requirements for hospitals as part of the Outpatient Prospective Payment System proposed rule for 2025. The proposed requirements would set baseline standards for hospitals around staffing, obstetrical care delivery and emergency services readiness, among other topics. The move represents the first time CMS has floated obstetrical requirements for hospitals and comes as the Biden administration aims to reduce maternal mortality and morbidity.
The American Hospital Association said it "fully shares" CMS' goal of improving maternal health, but is "deeply concerned" about the agency's excessive use of the conditions of participation to implement its policy agenda.
"We believe a less punitive and more collaborative and flexible approach is far superior," AHA said July 10. "We will carefully review CMS' proposals to determine whether they are feasible, sufficiently flexible for the wide variety of hospitals to which they would apply and do not inadvertently exacerbate maternal care access challenges."
The American College of Obstetricians and Gynecologists, which represents more than 60,000 OB-GYNs nationwide, echoed AHA's concerns.
Implementing additional conditions of participation requirements for obstetric units could inadvertently destabilize obstetric care and significantly limit access to care for patients who need it most, according to Lisa Satterfield, ACOG's senior director of health and payment policy.
"If the goal is to eliminate preventable maternal mortality and inequities in maternal health outcomes, any new policies must be crafted in a thoughtful, meticulous manner that utilizes evidence, recognizes barriers, and improves access to quality care for all patients seeking obstetric services," she said in a July 11 statement to Becker's.
CMS is seeking comments on the proposed rule through Sept. 9.