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40-2,160. Coverage for minimum inpatient care following birth of child.

40-2,160

Chapter 40.--INSURANCE
Article 2.--GENERAL PROVISIONS

      40-2,160.   Coverage for minimum inpatient care following birth of child.(a) As used in this section:

      (1)   "Health plan" means any insurer or corporation which issuesindividual and group health insurance policies providing coverage on anexpense-incurred basis, individual and group service or indemnity-typecontracts issued by a profit or nonprofit corporation and all contracts issuedby health maintenance organizations organized or authorized to transactbusiness in this state;

      (2)   "attending physician" means the person licensed to practice medicine andsurgery who is responsible for the care provided to the mother or newborn.

      (b)   Any health plan which provides coverage for maternity services,including benefits for childbirth, shall provide coverage forat least 48 hours of inpatient care following a vaginal delivery and at least96 hours of inpatient care following delivery by caesarean section for amother and newly born child in a medical care facility.

      (c)   Any decision to shorten the length of inpatient stay to less than thatprovided under subsection (b) shall be made by the attending physician.No health plan may terminate the service of, penalize or otherwiseprovide financial disincentives in response to any attending physician whoorders careconsistent with the provisions of this section.

      (d)   Notwithstanding the provisions of subsection (b), any health plan whichprovides coverage for postdelivery care provided to a mother and newly bornchild in the home, shall not be required to provide coverage of inpatient careunder subsection (b), unless such inpatient care is determined to be medicallynecessary by the attending physician.

      (e)   All health plans shall provide written notice, as currently required, toall enrollees, insureds or subscribers regarding the coverage required by thissection.

      History:   L. 1996, ch. 96, § 1; Apr. 11.

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