§ 27-18-33.1 - Insurance coverage for post-partum hospital stays. - Rhode Island Statutes

SECTION 27-18-33.1

   § 27-18-33.1  Insurance coverage forpost-partum hospital stays. – (a) Every individual or group hospital or medical services plan contractdelivered, issued for delivery, as renewed in this state which providesmaternity benefits shall provide coverage for a forty-eight (48) hour timeperiod in a hospital after a vaginal birth and ninety-six (96) hours after aCesarean section for a mother and her newly born child. Any decision to shortenthis minimum coverage shall be made by the attending health care provider inconsultation with the mother. The decision shall be made in accordance with thestandards for guidelines for perinatal care published by the American Collegeof Obstetrics and Gynecology and the American Academy of Pediatrics. Thestandards shall be relative to early discharge, defined as less thanforty-eight (48) hours for a vaginal delivery and ninety-six (96) for aCesarean delivery. In the case of early discharge, post-delivery care shallinclude: home visits, parent education, assistance and training in breast orbottle feeding and the performance of any necessary and appropriate clinicaltests or any other tests or services consistent with these guidelines.

   (b) For the purposes of this section, "attending health careprovider" includes the attending obstetrician, pediatrician, familypractitioner, general practitioner or certified nurse midwife attending themother and newly born child.

   (c) Any subscriber who is aggrieved by a denial of benefitsto be provided under this section may appeal the denial in accordance withregulations of the department of health, which have been promulgated pursuantto chapter 17.12 of title 23. No policy or plan covered under this chaptershall terminate the services, reduce capitation payment, or penalize anattending physician or other health care provider who orders care consistentwith the provisions of this section.