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PAG LIN
1 1 Section 1. NEW SECTION. 514C.11 POSTDELIVERY CARE
1 2 REQUIREMENTS.
1 3 1. Notwithstanding section 514C.6, an individual or group
1 4 policy of accident or health insurance or individual or group
1 5 hospital or health care service contract issued pursuant to
1 6 chapter 509, 514, or 514A or an individual or group health
1 7 maintenance organization contract issued and regulated under
1 8 chapter 514B, which is delivered, amended, or renewed on or
1 9 after July 1, 1996, and which provides benefits for maternity
1 10 or newborn care or services shall not terminate inpatient
1 11 benefits or require discharge from the hospital of a mother or
1 12 newborn, following delivery, earlier than is determined to be
1 13 medically appropriate by the attending physician following
1 14 consultation with the mother and in accordance with the most
1 15 recent guidelines for perinatal care established by the
1 16 American academy of pediatrics and the American college of
1 17 obstetricians and gynecologists.
1 18 2. If follow-up care, subsequent to the discharge of the
1 19 mother or newborn, is determined by the attending physician to
1 20 be medically appropriate in accordance with the most recent
1 21 guidelines for perinatal care established by the American
1 22 academy of pediatrics and the American college of
1 23 obstetricians and gynecologists, coverage shall be provided
1 24 for the follow-up care under any policy provided by a person
1 25 who provides an individual or group policy of accident or
1 26 health insurance or individual or group hospital or health
1 27 care services contract issued pursuant to chapter 509, 514, or
1 28 514A or an individual or group health maintenance organization
1 29 contract issued and regulated under chapter 514B, which is
1 30 delivered, amended, or renewed on or after July 1, 1996.
1 31 3. When performing utilization review of inpatient
1 32 hospital services related to maternity and newborn care,
1 33 including but not limited to length of stay, any person who
1 34 provides an individual or group policy of accident or health
1 35 insurance or individual or group hospital or health care
2 1 service contract issued pursuant to chapter 509, 514, or 514A
2 2 or an individual or group health maintenance organization
2 3 contract issued and regulated under chapter 514B, which is
2 4 delivered, amended, or renewed on or after July 1, 1996, shall
2 5 use the most recent guidelines for perinatal care established
2 6 by the American academy of pediatrics and the American college
2 7 of obstetricians and gynecologists.
2 8 EXPLANATION
2 9 This bill provides that a person who provides an individual
2 10 or group policy of accident or health insurance, an individual
2 11 or group hospital or health care service contract, or an
2 12 individual or group health maintenance organization contract,
2 13 which is delivered, amended, or renewed on or after July 1,
2 14 1996, and which provides benefits for maternity or newborn
2 15 care or services, shall not terminate inpatient benefits or
2 16 require the discharge of a mother or newborn from the hospital
2 17 following delivery earlier than is medically appropriate based
2 18 upon a determination by the attending physician in
2 19 consultation with the mother and in accordance with the most
2 20 recent guidelines for perinatal care established by the
2 21 American academy of pediatrics and the American college of
2 22 obstetricians and gynecologists. The bill also requires that
2 23 when a mother or newborn requires follow-up care after
2 24 discharge from the hospital as determined by the attending
2 25 physician in accordance with the guidelines, coverage is to be
2 26 provided by any of the abovenamed entities. The bill requires
2 27 that when any of the abovenamed entities is performing
2 28 utilization review of inpatient hospital maternity and newborn
2 29 care services, including but not limited to inpatient length
2 30 of stay, the entity is to use the most recent guidelines for
2 31 perinatal care established by the American academy of
2 32 pediatrics and the American college of obstetricians and
2 33 gynecologists.
2 34 LSB 3593SS 76
2 35 pf/jw/5
Text: SF02124 Text: SF02126 Text: SF02100 - SF02199 Text: SF Index Bills and Amendments: General Index Bill History: General Index
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