Connecticut to launch Medicaid maternity bundle Jan. 1 after CMS State Plan Amendment approval

The Connecticut Department of Social Services will begin an episode‑based maternity payment model Jan. 1, 2025, after receiving CMS approval via a State Plan Amendment, agency presenters said during a December provider forum.

DSS said the CMS approval was granted on Nov. 20, 2024, and the State Plan Amendment is effective Jan. 1. The department described the “maternity bundle” as an episode of care that runs from conception through 90 days postpartum and includes new covered services such as doula and lactation support.

Why it matters: DSS officials said the bundle is intended to strengthen maternal health, improve equity and outcomes, and reduce unnecessary spending. Presenters cited that Medicaid covered about 45% of Connecticut births and that the state’s C‑section rate was about 33% in 2020, framing the payment change as part of broader efforts to change incentives and accountability for perinatal care.

How it will work: Under the new model, participating practices that meet eligibility criteria will receive provider‑specific case‑rate payments beginning in the second trimester and continuing through 90 days postpartum. DSS described three trigger criteria to…