Texas Physicians Helping Draft Maternal Patient Care Rules

Physicians from several state pediatric, maternal, and general medical societies sounded off recently on draft proposed rules regarding the levels of care hospitals must provide maternity patients.

The Texas Department of State Health Services (DSHS) and the Perinatal Advisory Council (PAC) sought the input, which will be reviewed and incorporated, as appropriate, before being opened to formal public comment.

A state law that went into effect in 2013 directed DSHS and PAC to develop the hospital care levels for neonatal and maternity services. The neonatal rules took effect in June 2016. Hospitals must obtain designation by Sept. 1, 2018, in order to receive Medicaid reimbursement for neonatal services.

For maternal levels of care, the law requires the state to complete hospital designations by March 1, 2019. The draft rules propose four levels:  

  • Level 1 — basic/well nursery;
  • Level 2 — specialty care;
  • Level 3 — subspecialty care;
  • Level 4 — comprehensive care.  

In a letter dated June 20, leaders from the TMA, the American Congress of Obstetricians and Gynecologists (ACOG)-Texas Chapter, the Texas Academy of Family Physicians, and more presented a series of proposed rule changes based on physician feedback.

“On balance, the physicians who submitted comments to our organizations strongly favored the rules, though not surprisingly, some provisions will require greater clarification and wordsmithing,” the letter said.

Most of the letter recommended technical changes, but the letter expressed concern that the draft proposed rules did not sufficiently distinguish between Level III and Level IV facilities.  Clearer distinctions will make it easier for hospital medical staffs and administrators to determine the services most appropriate for their facilities as well as reduce duplication of services. TMA and specialty societies recommended that DSHS revise the draft Level IV rules to reflect the Level IV ACOG standards. 

Formal rules will be published in the Texas Register later this year, at which time TMA, specialty societies, and other interested physicians will have 30 days to submit formal comments.  

Action, July 5, 2017

Last Updated On

July 06, 2017

Related Content

Womens Health