Maternal Health Policy Reform 2025: HHS and CMS Unveil Sweeping Proposals
In a landmark move towards comprehensive Maternal Health Policy Reform 2025, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have announced a far-reaching set of proposed policies. These proposed reforms are designed to tackle the urgent maternal health challenges and ongoing disparities in healthcare across the United States, representing a pivotal advancement in the development of maternal care policies
The proposed changes, part of the Calendar Year 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) rule, represent a cornerstone of the Biden-Harris Administration’s commitment to improving maternal health outcomes and advancing health equity. This 2025 maternal health reform package is poised to reshape the landscape of maternal care across the nation.
Key Components of the Maternal Health Policy Reform 2025:
Maternal Care Standards: CMS is introducing new baseline health and safety requirements for obstetrical services in hospitals and critical access hospitals for the first time. These standards, a core element of the 2025 maternal health reforms, will set guidelines for staffing, care delivery, and emergency preparedness.
Health Equity Measures: As part of the policy changes for maternal care, the proposal aims to expand quality program measure sets for hospital outpatient, ASC, and rural emergency hospital programs to include equity-focused metrics.
Support for Tribal Health: The Maternal Health Policy Reform 2025 includes an add-on payment to the All-Inclusive Rate (AIR) for certain Indian Health Services (IHS) and tribal facilities. This aims to increase access to high-cost drugs, particularly benefiting cancer care services in these communities.
Medicaid Flexibility: Exceptions to the Medicaid clinic services “four walls” requirement are proposed, potentially increasing access to care in tribal, rural, and behavioural health settings – a crucial aspect of the 2025 maternal health reforms.
Post-Incarceration Coverage: The policy reform addresses a critical gap in care continuity by seeking to eliminate barriers for formerly incarcerated individuals to enroll in and maintain Medicare coverage.
Payment Updates: As part of the overall Maternal Health Policy Reform 2025, OPPS and ASC payment rates for CY 2025 are proposed to increase by 2.6% for facilities meeting quality reporting requirements.
CMS Administrator Chiquita Brooks-LaSure emphasized the importance of the proposed policy changes for maternal care, remarking, “This proposed rule is proof that we are committed to ensure people aren’t just covered, but that coverage is meaningful.”
The Maternal Health Policy Reform 2025 aligns closely with the White House Blueprint for Addressing the Maternal Health Crisis. It represents a multi-faceted approach to tackling healthcare disparities, acknowledging the disproportionate impact of maternal mortality on women of color and those in rural communities.
Healthcare providers, policymakers, and stakeholders have until September 9, 2024, to submit comments on the proposed rule. The final implementation of these 2025 maternal health reforms could mark a pivotal shift in how maternal health and health equity are addressed in the U.S. healthcare system.
As the healthcare landscape continues to evolve, staying informed about these policy changes is crucial for healthcare organizations to adapt and provide the best possible care to their communities. The Maternal Health Policy Reform 2025 stands as a testament to the ongoing commitment to improve maternal health outcomes across the nation.