Health Maintenance Organizations
§ 27-41-30.1 Post-partum hospital stays.
(a) Every individual or group hospital or medical services plan contract
delivered, issued for delivery, or 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 after 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 guidelines in this subsection.
(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 member 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, § 5; P.L. 1996, ch. 260, § 5; P.L. 2002, ch.
292, § 85.)