On November 5, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule Cutting Administrative Requirements for Excellence in Patient Care. AWHONN has significant concerns regarding provisions of the proposed rule that would eliminate maternal-health-specific staff training requirements and remove obstetric quality assessment and performance improvement (QAPI) requirements for hospitals providing maternity care. AWHONN will submit comments in response to this proposed rule to bring our concerns to CMS's attention.

Nurses are on the front lines of caring for pregnant and postpartum patients, newborns, and families. Consistent, evidence-based education and ongoing quality improvement are essential components of safe maternity care. Standardized obstetric training helps healthcare teams recognize and respond to maternal emergencies, improve communication, reduce preventable harm, and support equitable care delivery.

The United States continues to face unacceptable rates of maternal morbidity and mortality, with disproportionately poor outcomes among Black, Indigenous, rural, and other medically underserved populations. At a time when healthcare leaders across the country are working to improve maternal health outcomes, AWHONN believes it is essential to preserve evidence-based standards that promote obstetric readiness, workforce competency, and accountability for quality care.

Patient safety initiatives should never be considered an administrative burden. Policies should reduce unnecessary administrative burden throughout an organization or system while preserving the training, readiness, and quality improvement requirements that support safe care for women and newborns. We urge CMS to retain these patient safety and quality improvement requirements.

When a federal agency proposes a rule, it must accept and consider comments. AWHONN will be submitting comments on this proposed rule. Would you submit comments, too? Your comments would help to discourage CMS from enacting this rule as written. Click the following link to submit your comment at Regulations.gov.

Sample comment language can include:

“I encourage CMS to retain obstetric staff training, emergency readiness training, and maternal quality improvement requirements. Removing these requirements could place patients at undue risk. Examples from my own practice include …”  Share examples from your practice demonstrating how these safeguards support patient safety.