Providing that certain limits on State-directed payments under the Medicaid program not apply to certain maternity, labor, and delivery services

Section 71116(b) of an Act to provide for reconciliation pursuant to title II of H. Con. Res. 14 (Public Law 119–21) is amended— (1) in the header, by striking Grandfathering and inserting Treatment of; (2) by striking In the case of and inserting the following: (1) Grandfathering In the case of; and (3) by adding at the end the following new paragraph: (2) Exemption for payments for certain maternity, labor, and delivery services In the case of a payment described in section 438.6(c)(2)(iii) of title 42, Code of Federal Regulations (or a successor regulation), made for maternity, labor, or delivery services furnished during a rating period beginning on or after July 4, 2025, by a specified entity, no limit on such payment shall apply. (3) Definitions In this subsection: (A) Qualifying births The term qualifying birth means, with respect to a birth at a hospital, any birth with respect to which the individual giving birth— (i) received maternity, labor, or delivery services for which payment for such services was made in whole or in part under— (I) a State plan under title XIX of the Social Security Act (or waiver of such plan); (II) a State child health plan under title XXI of such Act (or a waiver of such plan); or (III) title XVIII of such Act; (ii) received maternity, labor, or delivery services provided by the Indian Health Service or a Native Hawaiian health care system (as defined in section 12 of the Native Hawaiian Health Care Improvement Act); or (iii) did not have minimum essential coverage (as defined in section 5000A(f) of the Internal Revenue Code of 1986) and for which the hospital incurred uncompensated care costs (other than charity care costs). (B) Specified entity The term specified entity means any of the following entities: (i) A rural hospital. (ii) A hospital operated by the Indian Health Service or by an Indian Tribe under the Indian Self-Determination and Education Assistance Act. (iii) A hospital for which, with respect to the most recent 12-month period for which data is available, at least 50 percent of all births at such hospital were qualifying births..