Changes to Maternal Designation Rules


Senate Bill 749 Updates Maternal Designation Requirements


About the Program

As part of the fight to reduce maternal mortality and morbidity, Texas law now requires all hospitals that provide maternity services receive a maternal level of care designation by Aug. 31, 2021 to receive Medicaid reimbursement for obstetrical care.

In response, ACOG launched a new program to provide survey services for Texas hospitals. We collaborated with local physicians and key organizations, opened a Texas-based office; and recruited more than 130 Texas-based obstetrician–gynecologists, maternal nurses, and maternal-fetal medicine specialists to serve as surveyors through the program.

Our process provides a local, confidential, and collegial survey that adheres to the Texas Administrative Code and focuses on quality and collaboration.

Why Choose ACOG?

As leaders in the fight to reduce maternal mortality and morbidity, ACOG is uniquely positioned to perform site surveys. We will:

  • Perform the site survey in compliance with the Texas Administrative Code
  • Utilize a collaborative approach that is consistent, fair, and in line with the highest degree of professionalism and confidentiality
  • Provide objective and neutral documentation
  • Partner with hospital leadership throughout the process
  • Offer an optional confidential consultation at no extra charge to address any concerns expressed by the facility

The Process


  • Contact us for a free pre-survey consultation
  • Submit a survey application
  • Work with ACOG to select a survey date
  • Complete and submit contract, pre-assessment form, and policies and procedures

Site Visit Day 1

  • Medical record review
  • Dinner with hospital and medical staff to hear about the maternal program and ask questions

Site Visit Day 2

  • Interviews with staff
  • Tour of facility
  • Debriefing session to discuss findings, clarify any concerns, and provide consultation


Medical Record Review forms, completed site audit form, and a summary report are provided to the facility. Forms are submitted with the facility's DSHS application for designation. The summary report is retained by facility and not included with DSHS application.