TITLE 27

Insurance

CHAPTER 27-19

Nonprofit Hospital Service Corporations

SECTION 27-19-23.1



   § 27-19-23.1  Insurance coverage for

post-partum hospital stays. –

(a) Every individual or group hospital or medical services plan contract

delivered, issued for delivery, as renewed in this state shall provide coverage

for a forty-eight (48) hour time period in a hospital after a vaginal birth and

ninety-six (96) hours for a Cesarean section for a mother and her newly born

child. Any decision to shorten these minimum coverages shall be made by the

attending health care provider in consultation with the mother. The decision

shall be made in accordance with the standards for guidelines for perinatal

care published by the American College of Obstetrics and Gynecology and the

American Academy of Pediatrics. The standards shall be relative to early

discharge, defined as less than forty-eight (48) hours for a vaginal delivery

and ninety-six (96) for a cesarean delivery. In the case of early discharge,

post-delivery care shall include home visits, parent education, assistance and

training in breast or bottle feeding and the performance of any necessary and

appropriate clinical tests or any other tests or services consistent with the

above guidelines.



   (b) For the purposes of this section, "attending health care

provider" includes the attending obstetrician, pediatrician, family

practitioner, general practitioner, or certified nurse midwife attending the

mother and newly born child.



   (c) Any subscriber who is aggrieved by a denial of benefits

to be provided under this section may appeal the denial in accordance with

regulations of the department of health, which have been promulgated pursuant

to chapter 17.12 of title 23. No policy or plan covered under this chapter

shall terminate the services, reduce capitation payment, or penalize an

attending physician or other health care provider who orders care consistent

with the provisions of this section.



History of Section.

(P.L. 1996, ch. 246, § 3; P.L. 1996, ch. 260, § 3; P.L. 2002, ch.

292, § 37.)