Medicare proposes dropping hospital obstetric rules weeks before they take effect

Federal regulators proposed Tuesday to scrap rules, set to take effect Jan. 1, that would require hospitals that deliver babies to train staff in obstetric care and run programs to improve maternal health.

The Centers for Medicare & Medicaid Services finalized the rules in 2024 as its first standards written specifically for obstetric care. They would require hospitals to track outcomes for mothers, run at least one improvement project a year and use findings from maternal death review committees where they exist.

CMS said it changed course after physician groups, medical associations and rural health advocates warned that the cost could push small and rural hospitals to close their labor and delivery units. The agency estimates the rules would cost hospitals about $430 million over 10 years. It said hospitals' general quality rules would still cover obstetric care.

In Alaska, the state's review committee examined 16 deaths during or within a year of pregnancy from 2021 through 2024 and found all but one preventable. Many rural Alaskans already fly to deliver, sometimes waiting weeks in Anchorage for labor to start.

Comments on the proposal are due Jan. 11, 2027.