Policy Tracker
Federal and state policy developments that affect the reimbursement environment, funding landscape, and operating context for maternal and pediatric health companies.
HRSA Finalizes Revised Criteria for Maternity Care Health Professional Target Areas
HRSA finalized revised MCTA criteria removing the Social Vulnerability Index from scoring and reallocating its two points to population-to-provider ratios and travel time. The change affects which geographies qualify for NHSC loan repayment and where federally supported maternity providers are placed.
HHS Launches Psychiatric Overprescribing Action Plan
HHS announced a MAHA action plan targeting psychiatric overprescribing with explicit focus on children and adolescents, including CMS deprescribing guidance, a Dear Colleague letter, and planned SAMHSA/FDA activities. Signals a federal posture shift that creates headwinds for medication-forward behavioral health models and tailwinds for therapy and care-navigation platforms.
CMS ASPIRE Model — Pediatric Complex Care Medicaid Initiative
CMS launched ASPIRE, a 10-year voluntary state-based program allocating $125M for up to five states to deliver whole-person care for Medicaid and CHIP enrollees up to age 21 with complex conditions. Applications closed May 17. State ASPIRE contracts will be among the most valuable pediatric value-based care opportunities of 2027.
Nebraska Becomes First State to Implement OBBBA Medicaid Work Requirements
Nebraska became the first state to implement Medicaid work requirements on May 1, 2026, eight months ahead of the OBBBA federal deadline. Pregnant women, mothers up to 12 months postpartum, and children are explicitly exempt.
North Carolina Proposes Sweeping ABA Medicaid Oversight Revisions
NC DHHS proposed revisions to Clinical Coverage Policy 8F that would tighten ABA provider oversight and restrict telehealth for ABA service delivery — the first major state-level ABA tightening signal of 2026.
FDA Approves Otarmeni for Genetic Hearing Loss
FDA approved Otarmeni (lunsotogene parvec-cwha) for severe-to-profound sensorineural hearing loss tied to biallelic OTOF variants — the first dual AAV vector-based gene therapy and first approved gene therapy for inherited hearing loss.
Virginia DMAS RFI — Maternal Health Desert Mobile Clinic Pilot Program
Virginia DMAS opened RFI-118360 for a Maternal Health Desert Mobile Clinic Pilot Program on April 17, 2026 — a state purchasing signal for mobile clinic operators, prenatal and postpartum telehealth platforms, and maternal care-coordination vendors.
Florida KidCare CHIP Expansion Stalled — 42,000 Children Still Waiting
Two years after Florida lawmakers unanimously passed an expansion of KidCare (200% to 300% FPL), approximately 42,000 children remain uninsured and waiting. A lawsuit filed in March 2026 seeks to compel AHCA to implement the law.
FDA Clears Earflo At-Home Pediatric Ear Pressure Treatment
Earflo received FDA clearance for its at-home device for children as young as two with negative middle-ear pressure and fluid buildup, positioned as an option during the watchful-waiting period before ear tube surgery.
Maine Budget Creates Reproductive Health Funding Shield Against Federal Cuts
Maine's 2026 budget proposes $5M/year beginning in 2027 to replace federal reproductive health funding if cut, and would have the state absorb Medicaid reimbursement costs if federal support is reduced — a Tier One Defender posture in the emerging state policy landscape.
Wisconsin Extends Postpartum Medicaid Coverage to 12 Months
Wisconsin enacted SB 23 extending postpartum Medicaid from 60 days to 12 months for eligible birthing parents, effective July 1, 2026 pending federal approval.
Title V MCH Block Grant — Georgetown CCF Advocacy Report on State Dependence and Funding Gaps
Georgetown CCF documented state reliance on Title V MCH funding and argued that $818.70M in FY2026 appropriations is structurally insufficient to address maternal and infant mortality.