Navigating New CMS Obstetrical Service Requirements

The healthcare landscape is constantly evolving, and staying compliant with new regulations is essential for providing high-quality care and ensuring a smooth operational flow. With the Centers for Medicare and Medicaid Services (CMS) introducing new Conditions of Participation (CoPs) for hospitals and Critical Access Hospitals (CAHs) providing obstetrical (OB) services, it’s crucial to be prepared. At WrightCare Consulting, we are here to help you navigate these changes and ensure your facility is ready for the January 1, 2026, deadline.

Understanding the New CMS Requirements

In November 2024, CMS released the 2025 Final Rule for the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System. This rule includes new CoPs specifically for OB services, which will be implemented in a phased rollout. The requirements effective January 1, 2026, focus on key areas to ensure safe and effective patient care:

• Organization and Delivery of Services: OB services must be well-organized and align with nationally recognized, evidence-based standards. The scope and complexity of services should be appropriate for your facility's capabilities and seamlessly integrated with other departments like laboratory, surgical services, and anesthesia.

  
  

• Policies and Protocols: Your hospital must have readily available policies, protocols, equipment, and supplies that are aligned with national guidelines for managing OB emergencies, complications, immediate postpartum care, and other critical safety events.

  
  

• Supervision and Staffing: OB patient care units, including labor, delivery, and postpartum areas, must be supervised by qualified personnel such as experienced registered nurses (RNs), certified nurse midwives, nurse practitioners (NPs), physician assistants (PAs), or physicians.

  
  

• Privileging: Hospitals must establish written criteria for granting OB privileges and maintain a current roster of all practitioners, including non-physician providers, and their specific privileges.

  
  

• Equipment: A minimum set of OB-specific equipment must be maintained and easily accessible. This includes a call-in system, cardiac monitor, and a fetal doppler or fetal monitor, with the type and availability of equipment consistent with the scope, volume, and complexity of services provided.

  
  

How WrightCare Consulting Can Help

Preparing for these new requirements can be complex, but you don't have to do it alone. WrightCare Consulting specializes in assisting hospitals and CAHs in adapting to new regulations. We can help you:

• Review and Revise Policies: We will work with you to review your current policies and protocols, helping you update them to meet the new CMS standards.

  
  

• Assess Staffing and Privileging: We can assist in evaluating your staffing models and developing clear, compliant criteria for granting and maintaining OB privileges.

  
  

• Ensure Operational Alignment: Our team can help you integrate OB services with other departments and ensure your equipment and supplies are aligned with national guidelines and the new CoPs.

  
  

• Develop Compliance Tools: We can provide guidance on creating and implementing the necessary compliance tools, ensuring your facility is fully prepared for the new requirements.

  
  

Don't wait until the last minute. The January 1, 2026, deadline is approaching. Let WrightCare Consulting be your trusted partner in ensuring your hospital's obstetrical services are compliant, safe, and ready for the future.

For more information, contact us today at info@wrightcareconsulting.org to schedule a consultation.