CMS Unveils New Policies to Boost Maternal Health, Access to Care, and Health Equity

In a groundbreaking move, the Centers for Medicare & Medicaid Services (CMS) has introduced new policies aimed at transforming the landscape of maternal healthcare, improving access to services for formerly incarcerated individuals, and advancing health equity. These policies are part of the 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule, which includes vital updates to safety standards, payment rates, and patient support programs.

Raising Maternal Health Standards

As part of the new rule, CMS is setting national safety and quality requirements for hospitals and Critical Access Hospitals (CAHs) providing obstetrical (OB) services. This includes enforcing baseline standards for staffing, care delivery, and emergency readiness in OB units. Hospitals will be required to implement evidence-based maternal health practices and train staff to handle obstetric emergencies effectively.

“CMS is committed to addressing our nation’s maternity care crisis. These measures are the first-ever national maternal health and safety standards for hospitals, a crucial step in safeguarding mothers and newborns,” said CMS Administrator Chiquita Brooks-LaSure.

Expanding Behavioral Health Access and Cancer Care for Tribal Communities

The new policies also tackle the opioid crisis by increasing access to non-opioid pain relief options. Hospitals will now receive additional payments for non-opioid drugs and medical devices that aid in post-operative pain relief, supporting CMS’s behavioral health goals and reducing opioid reliance.

For tribal communities, the rule enhances access to high-cost drugs for treating cancer, aligning with the Biden-Harris Administration’s Cancer Moonshot initiative. Indian Health Services (IHS) and tribal hospitals will now receive additional funding to help patients in these communities afford necessary cancer treatments.

Reducing Barriers for Formerly Incarcerated Individuals

To promote health equity, CMS has expanded Medicare access for individuals on bail, parole, probation, or home detention. By doing so, CMS is addressing health access disparities for those reintegrating into society, including expanded eligibility for a special enrollment period for Medicare.

“Patients deserve access to care and pain relief, especially during critical transitions like post-incarceration. This rule is a significant step in closing the health disparity gap,” said Dr. Meena Seshamani, Deputy Administrator and Director of CMS’ Center for Medicare.

Expanded Medicaid Services

The 2025 OPPS/ASC final rule extends Medicaid coverage for clinic services outside traditional clinic walls, allowing states to offer Medicaid benefits in rural and behavioral health clinics. It also codifies continuous eligibility for children enrolled in Medicaid and CHIP for 12 months, ensuring uninterrupted care for the youngest and most vulnerable populations.

CMS’s latest updates aim to enhance patient safety, improve access to care, and support underserved communities, ensuring equitable healthcare for all.

For more detailed information, visit the www.cms.gov