- GAO Seeks New Members for Tribal and Indigenous Advisory Council
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- Telehealth Study Recruiting Veterans Now
- USDA Delivers Immediate Relief to Farmers, Ranchers and Rural Communities Impacted by Recent Disasters
- Submit Nominations for Partnership for Quality Measurement (PQM) Committees
- Unleashing Prosperity Through Deregulation of the Medicare Program (Executive Order 14192) - Request for Information
- Dr. Mehmet Oz Shares Vision for CMS
- CMS Refocuses on its Core Mission and Preserving the State-Federal Medicaid Partnership
- Social Factors Help Explain Worse Cardiovascular Health among Adults in Rural Vs. Urban Communities
- Reducing Barriers to Participation in Population-Based Total Cost of Care (PB-TCOC) Models and Supporting Primary and Specialty Care Transformation: Request for Input
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- Secretary Kennedy Renews Public Health Emergency Declaration to Address National Opioid Crisis
- 2025 Marketplace Integrity and Affordability Proposed Rule
- Rural America Faces Growing Shortage of Eye Surgeons
- Comments Requested on Mobile Crisis Team Services: An Implementation Toolkit Draft
CMS Issues New Hospital Maternal Health, Safety Standards: Things to Know
From Becker’s Clinical Leadership
To address the maternal health crisis in the U.S., CMS has issued new conditions of participation standards for hospitals that offer obstetrical services as part of its 2025 Hospital Outpatient Prospective Payment System rule shared Nov. 1.
The new requirements will ensure all Medicare- and Medicaid-participating hospitals offering obstetric services are “held to a consistent standard of high-quality maternity care that protects the health and safety of pregnant, birthing and postpartum patients,” according to a Nov. 1 CMS fact sheet.
Here are things nine to know about the new standards:
- Hospitals must meet the maternal health conditions to avoid termination from Medicare and Medicaid.
- CMS is finalizing a phased implementation plan for the new requirements to address potential burdens raised during public feedback. The planned implementation will start in 2026 and occur in three phases over two years.
- Among the new requirements for organization and staffing are:
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- Obstetric services be “well organized” and in line with nationally recognized stands of healthcare. Services should also be appropriately integrated with other departments in the facility.
- All obstetric units be supervised by an appropriately trained individual, such as an experienced registered nurse, nurse practitioner, certified midwife, physician assistant, MD or DO.
- Obstetric privileges should be granted for all providers in the unit in accordance with current hospital requirements.
- Requirements for service delivery are:
- Basic obstetric equipment be kept at the facility and readily available with respect to the facility’s scope, volume and complexity of services offered.
- Facilities have facility provisions and protocols for emergencies, complications and post-delivery care that are consistent with nationally recognized and evidence-based guidelines.
- Requirements for staff training are:
- Hospitals develop and ensure all obstetric staff have been trained on policies and procedures that improve the delivery of maternal care. Training must be documented and reviewed every two years.
- Hospitals use findings from quality assurance and performance improvement programs to revise procedures and protocols.
- Requirements for quality assurance and performance improvement programs are:
- Hospitals use its quality assurance and performance improvement program to collect and analyze data to develop action plans to address health disparities and improve outcomes among obstetric patients.
- If a maternal mortality review committee is available in a hospital’s geographical region, the hospital must incorporate publically available data into its quality assurance and performance improvement program.
- Requirements for emergency services are:
- All hospitals that provide emergency services have adequate provisions and protocols to meet the needs of obstetric patients, regardless of whether the facility provides obstetric services. The provisions and protocols must be consistent with nationally recognized and evidence-based guidelines.
- All emergency services staff have undergone documented training on the protocols and provisions.
- Facilities have provisions set aside for obstetric emergencies.
- Requirements for transfer protocols are:
- Hospitals have policies and procedures for obstetric patient transfer. All relevant staff must be trained on the transfer policies and procedures.
Rural Pennsylvania Impacted the Most by Medical Debt
Medical debt is an issue that disproportionately impacts rural Pennsylvanians. Efforts to reduce medical debt have been thwarted by legislators representing those communities. Read more.
The 340B Program Reached $66 Billion in 2023—Up 23% vs. 2022: Analyzing the Numbers and HRSA’s
Reality has again failed to support the spin surrounding the 340B Drug Pricing Program. For 2023, discounted purchases under the 340B program reached a record $66.3 billion—an astounding $12.6 billion (+23.4%) higher than its 2022 counterpart. The gross-to-net difference between list prices and discounted 340B purchases also grew, to $57.8 billion (+$5.5 billion). 340B purchases are now almost 40% larger than Medicaid’s prescription drug purchases. Hospitals again accounted for 87% of 340B purchases for 2023. Purchases at every 340B covered entity type grew, despite drug prices that grew more slowly than overall inflation. Read the article for full details and our analysis.
The 2025 Medicare Open Enrollment Period has Begun
Medicare Open Enrollment runs from Oct. 15 through Dec. 7. CMS has released resources for partners to use when encouraging patients to review their Medicare plan. Key resources includes an open enrollment and social media toolkit.
Pennsylvania Rolls Out Health Insurance Transparency Report, Process of How to Appeal Claim Denials
The Pennsylvanian Insurance Department announced that the 2024 transparency in coverage report is now available online, including helpful information for consumers on what to do if their insurance company denies their claim. The report also outlines data on claims, claim denials, and appeals information for health insurers doing business in the Commonwealth.
Pennsylvania Announces Annual Update to SNAP Benefit Amounts, Changes to Income Limits
The Pennsylvania Department of Human Services (DHS) announced increases to Supplemental Nutrition Assistance Program (SNAP) income and benefit limits in Pennsylvania, following a yearly adjustment from the USDA’s Food and Nutrition Service (FNS). DHS also announced that the replacement of stolen SNAP benefits – which DHS began offering in 2023 – has been extended to benefits stolen through December 20, 2024.
It’s Here! Open Enrollment 2025 in Pennsylvania!
Open Enrollment for Pennsylvania’s health insurance marketplace, Pennie, on November 1. For customers to get coverage for Jan. 1 coverage, they must enroll and choose a plan by December 15. Although Open Enrollment does not end until January 15 it is important customers pay their first premium payment before the first date of coverage for it to be active. Financial savings through tax credits assist with lowering premiums and coverage costs. Enrollment Assisters can also request outreach materials from
Important Notice for Physicians Renewing Licenses in Pennsylvania
The Pennsylvania Department of Health is asking physicians to provide detailed and accurate information on the self-reported survey as part of the license renewal process. Maintaining accurate and current information on providers is essential for effectively analyzing, designing, and designating areas with health care workforce shortages across Pennsylvania. The Primary Care Office relies on these data to ensure that health care resources are allocated where they are needed most. Read this notice for more information.
Apply NOW for Pennsylvania A Primary Care Loan Repayment
The Pennsylvania Primary Care loan repayment program is open for applications. All practitioner applications are due by 11:59 pm on Friday, November15, 2024. This generous loan repayment program pays primary care physicians, dentists, and psychologists up to $80,000 for full time and up to $40,000 for half time. Other practitioners – including nurse practitioners, physician assistants, dental hygienists, licensed clinical social workers, and more, can receive up to $48,000 full time and up to $24,000 for half time. Read the loan repayment fact sheet for more information.
2024 Guideline for the Primary Prevention of Stroke Released
The American Heart Association (AHA)/American Stroke Association updated 2014 guidelines for primary prevention of stroke. The new guidance aligns with the AHA’s Life’s Essential 8 for optimizing cardiovascular and brain health and adds sex-specific suggestions for screening and prevention of stroke, including assessment of social determinants of health. The full guidelines are available.