Federal Policy
Given the Policy Center’s focus on improving maternal mental health (MMH) detection and treatment rates, we believe it’s critical that obstetric care providers (Ob/Gyns, midwives, and family practice doctors) are reimbursed for their time providing maternal mental health care. Currently, most obstetric care providers are not reimbursed for their time as many are when paid through a global maternity care bundled rate. This letter calls on CMS to provide guidance to state Medicaid agencies on the need to address reimbursement starting in pregnancy and through 12 months postpartum.
In recent years, mental health has emerged as a global public health priority and a matter of fundamental human rights. Many countries are recognizing the need to adopt or reform their mental health-related legislation. However, existing laws often fall short in addressing discrimination and human rights violations, particularly within mental health care settings. In response to this pressing issue, the World Health Organization (WHO) and the Office of the High Commissioner for Human Rights (OHCHR) have collaborated to develop a comprehensive publication titled “Mental Health, Human Rights, and Legislation: Guidance and Practice.”
In a move to address the alarming maternal health crisis in the United States, the Biden-Harris Administration has unveiled the 'Birthing-Friendly' designation on the Centers for Medicare & Medicaid Services (CMS) Care Compare online tool. This user-friendly tool aims to empower expectant parents by helping them identify hospitals and health systems committed to providing high-quality maternity care.
In October 2023, the Federal Health Resource and Services Administration (HRSA) announced the release of millions of dollars of investments into maternal health care. This included announcing the second round of funding for state maternal mental health programs. This funding was made possible through the Bringing Postpartum Depression Out of the Shadows Act, which was passed in 2017 (and led by the National Coalition for Maternal Mental Health, a prior project of the Policy Centers).
On July 25th, 2023, the Departments of Labor, Health and Human Services and the Treasury announced proposed rules to strengthen the Mental Health Parity and Addiction Equity Act. We have been honored to be a part of shaping these rules with the Department of Labor and The Kennedy Forum over the past several years. This week the Policy Center for Maternal Mental Health submitted the following letter in response to the proposed rules.
As part of the Federal government’s efforts to address maternal mental health in America, the Office of Women’s Health has developed an awareness campaign - starting with postpartum depression. The Policy Center is partnering with HHS on further addressing the range of maternal mental health disorders (MMH), detection in pregnancy, and incorporating the universal symbol of MMH, the blue dot, into future materials.
It’s an exciting time for maternal mental health for a number of reasons - and at the Policy Center, we are particularly excited to report that the new Federal Task Force on Maternal Mental Health launched on September 27.
The Policy Center for Maternal Mental Health submitted the following letter in response to the Centers for Medicare and Medicaid Services Proposed Physician Fee Schedule regarding peer support, community health workers, and social determinants of health, gleaning insights from our partners at Mental Health America and the American Association on Health and Disability.
In August 2023, the Center for Medicare and Medicaid Service (CMS) published a postpartum toolkit for State Medicaid and the Children’s Health Insurance Program (CHIP) Agencies titled Increasing Access, Quality, and Equity in Postpartum Care in Medicaid and CHIP. The toolkit addresses postpartum depression; however, we point out opportunities CMS missed, including addressing the role of the obstetric provider.
August 11th, 2023, the Equal Employment Opportunity Commission (EEOC) released a proposed rule for employers implementing the Pregnant Workers Fairness Act (PWFA), which addresses maternal mental health. The PWFA “prohibits employment practices that discriminate against making reasonable accommodations for qualified employees affected by pregnancy, childbirth, or related medical conditions.” The Policy Center for Maternal Mental Health submitted the following letter in response to the proposed rule for employers implementing the PWFA.
The Moms Matter Act (H.R. 3312/S. 1602), first introduced in 2021, was reintroduced this summer as part of the broader Momnibus bill package.
Medicaid utilizes the “Child and Adult Core Sets,” a set of quality measures, to measure the access and quality of care and to improve the quality of healthcare. Mathematica convenes the Child and Adult Core Set Annual Review Workgroup (“Workgroup”) to review and make recommendations for stronger measures. Joy Burkhard, our Executive Director, is a member of the Workgroup. This year’s Workgroup reviewed the 2025 Child and Adult Core Sets.
On July 25th, 2023, the Departments of Labor, Health and Human Services and the Treasury announced proposed rules to strengthen the Mental Health Parity and Addiction Equity Act. We have been honored to be a part of shaping these rules with the Department of Labor and The Kennedy Forum over the past several years and will be submitting a comment letter with our feedback on the rules soon.
Our work shaping and reporting on national mental health policy is made possible through a 2020-2023 capacity grant from the Perigee Fund.
The Affordable Care Act (ACA) requires private health plans and issuers of health insurance to cover the full range of birth control methods approved by the Food and Drug Administration (FDA) without cost-sharing. Although the contraceptive requirements in the ACA have expanded access to contraceptive products for millions of Americans, public reporting shows that people are still experiencing barriers to accessing full-range, FDA-approved contraception without cost-sharing.
This week the United States Preventive Services Task Force (USPSTF) expanded its recommendation to screen adults (including those who are pregnant) for anxiety in addition to depression. Additionally the USPSTF is not recommending universal suicide risk screening at this time.
On June 6th, 2023, the U.S. Department of Health and Human Services (HHS) and the Substance Abuse and Mental Health Services Administration (SAMHSA) published National Model Standards for Peer Support Certification for substance use, mental health, and family peer workers. These standards aim to accelerate the universal adoption, recognition, and integration of the peer mental health workforce across all elements of the healthcare system.
In April 2023, the Substance Abuse and Mental Health Service Administration (SAMHSA) released its Draft Strategic Plan for 2023 to 2026 and requested public comments. The Policy Center for Maternal Mental Health (the “Policy Center”) submitted the following letter in response to each priority area, with a particular focus on integrating behavioral and physical healthcare and strengthening the behavioral health workforce.
In February 2023, the Senate Committee on Health, Education, Labor, and Pensions (HELP) requested information from stakeholders on the drivers and potential solutions to healthcare workforce shortages. The Policy Center for Maternal Mental Health (formerly 2020 Mom) submitted the following letter outlining our recommendations to increase the capacity and diversity of the healthcare workforce.
Rep. Stewart shared, "I couldn't be prouder to co-chair this bipartisan caucus and elevate the conversation around mental health…suicide is a top ten cause of death nationwide, as well as in my home state. We are wholeheartedly committed to finding real-world, bipartisan solutions to help all Americans struggling with mental health challenges, and we will work tirelessly to uphold that commitment."
In honor of Black History Month, the Department of Health and Human Services (HHS) hosted a briefing on maternal health priorities and activities on Friday, 17th, 2023. Secretary Xavier Becerra and other key agency leaders shared new funding authorized by the passage of the federal budget bill (the Omnibus) and other Department activities to advance maternal health outcomes, including addressing inequities.
Certified Peer support is growing in interest as a means for building the mental health workforce. Peers have had similar mental health experiences and can help combat stigma, and support those who are suffering from mental health challenges in very meaningful ways.
Below is a summary from the Center for Connected Health Policy on the federal laws and regulations in place regarding telehealth, post the COVID Public Health Emergency.
What stays permanently:
Medicare reimbursement for eligible telehealth services when the patient is located in a geographically rural area AND in an eligible originating site (i.e. in most cases not the home).
The 117th Congress successfully passed the Consolidated Appropriations Act of 2023 on December 23, 2022 and is now headed to President Biden’s desk for signature.
The federal bill that 2020 Mom has championed, was passed by Congress and calls for the development of a national strategic plan to address maternal mental health.
In early December, our policy team worked with a coalition of non-profit partners and submitted the following letter to Congressional appropriations leaders, urging them to prioritize contraception care and safe motherhood. This is a priority for 2020 Mom and our coalition partners given the state of reduced availability of abortions in the United States and the link between unintended pregnancies and higher rates of poor mental health outcomes.
2022 was an important year for both federal mental health and maternal health policy. 2020 Mom led and supported critical pieces of legislation, engaged with key federal agencies, including the White House and CDC, and continued to serve as a top subject matter expert in not only maternal mental health policy, but also mental health parity and peer support.
CMS finalizes “Birthing-Friendly” hospital designations, available in Fall 2023.
“Birthing-Friendly” Hospital Designationsare defined as “a publicly-reported, public-facing hospital designation on the quality and safety of maternity care.”
A government report released in October confirms that during COVID, maternal health worsened, racial disparities grew, and rates of maternal mental health disorders rose.
Maternal deaths increased during the COVID-19 pandemic, and the pandemic was a contributing factor in 25% of all maternal deaths in 2020-2021, as found in the recent report published by the Government Accountability Office (GAO). GAO conducted this research because the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) includes a provision for GAO to report on its pandemic oversight efforts.
On July 24th, 2022, the Center for Medicare and Medicaid Services (CMS) released the Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Mental Health Crisis. Read our analysis of this White House’s Blueprint here. The Maternity Care Action Plan aims to decrease inequities among pregnant people and improve health outcomes.
In December, the federal Centers for Medicaid and Medicare Services (CMS) announced a new framework for supporting improved maternal healthcare delivery for Medicaid enrollees referred to as the Transforming Maternal Health (TMaH) Model.