§ 27-19-23.1 - Insurance coverage for post-partum hospital stays. - Rhode Island Statutes

SECTION 27-19-23.1

   § 27-19-23.1  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 shall provide coveragefor a forty-eight (48) hour time period in a hospital after a vaginal birth andninety-six (96) hours for a Cesarean section for a mother and her newly bornchild. Any decision to shorten these minimum coverages shall be made by theattending health care provider in consultation with the mother. The decisionshall be made in accordance with the standards for guidelines for perinatalcare published by the American College of Obstetrics and Gynecology and theAmerican Academy of Pediatrics. The standards shall be relative to earlydischarge, defined as less than forty-eight (48) hours for a vaginal deliveryand ninety-six (96) for a cesarean delivery. In the case of early discharge,post-delivery care shall include home visits, parent education, assistance andtraining in breast or bottle feeding and the performance of any necessary andappropriate clinical tests or any other tests or services consistent with theabove 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.