Grand Canyon Times

The Centers for Medicare & Medicaid Services (CMS) has introduced new health and safety standards for hospitals and Critical Access Hospitals (CAHs) offering obstetrical services. This initiative aims to enhance the safety of pregnancy, childbirth, and postpartum care. CMS is also working to improve access to healthcare for previously incarcerated individuals and those in underserved communities.

These policies are part of the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule. The rule updates payment rates for hospital outpatient and ASC services by 2.9% for 2025, potentially resulting in an additional $2.2 billion in payments compared to 2024.

"CMS is committed to addressing our nation’s maternity care crisis," stated CMS Administrator Chiquita Brooks-LaSure. She highlighted that the new rule expands access to behavioral health services, increases access to certain high-cost drugs for cancer patients in tribal communities, and addresses barriers to Medicare coverage for those formerly incarcerated.

The finalized requirements set baseline standards for obstetrical units regarding organization, staffing, delivery of care, quality assessment, performance improvement programs, and staff training on evidence-based maternal health practices.

“These new requirements build on CMS’ maternity care action plan,” said Dr. Dora Hughes from CMS’ Center for Clinical Standards and Quality. Hughes noted that emergency services readiness protocols will better prepare hospitals for obstetric emergencies.

The rule also implements policies aimed at reducing opioid use by providing additional payment for non-opioid pain relief drugs and medical devices with FDA-approved indications that reduce post-operative pain or opioid usage.

Another significant aspect of the final rule is its effort to improve health equity by removing barriers that prevent people with Medicare who are on bail or parole from accessing Medicare services. The eligibility criteria for a special enrollment period have been expanded to include these individuals.

“Together, these policies meaningfully impact health disparities by addressing equity and access barriers,” said Dr. Meena Seshamani from CMS’ Center for Medicare. She emphasized the importance of ensuring patients have access to necessary care across all communities.

Additionally, the final rule expands Medicaid coverage options outside traditional clinic settings in rural areas and codifies a requirement of 12 months of continuous eligibility for children enrolled in Medicaid and CHIP as part of broader efforts to reduce disparities in healthcare access.