SECOND REGULAR SESSION

HOUSE BILL NO. 1202

88TH GENERAL ASSEMBLY

INTRODUCED BY REPRESENTATIVE PROST.

Read 1st time January 18, 1996 and 1000 copies ordered printed.

DOUGLAS W. BURNETT, Chief Clerk

L3083.01I

AN ACT

To amend chapter 376, RSMo, by adding one new section relating to certain health insurance benefits following the birth of a child.

Be it enacted by the General Assembly of the state of Missouri, as follows:

Section A. Chapter 376, RSMo, is amended by adding one new section, to be known as section 376.1210, to read as follows:

376.1210. 1. Each entity offering individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description, that are delivered, issued for delivery, continued or renewed in this state on or after January 1, 1997, shall provide coverage for a minimum of forty-eight hours of in-patient care following a vaginal delivery and a minimum of ninety-six hours of in-patient care following a cesarean section for a mother and her newly born child in a health care facility licensed pursuant to chapter 197, RSMo.

2. Notwithstanding the provisions of subsection 1 of this section, any entity offering individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description may authorize a shorter length of hospital stay for services related to maternity and newborn care if:

(1) A shorter hospital stay meets with the approval of the attending physician and the mother; and

(2) The entity providing the individual or group health insurance policy authorizes an initial postpartum home visit for the mother and child which would include the collection of an adequate sample for the heredity and metabolic newborn screening. For the purposes of this section, "attending physician" shall include the attending obstetrician, pediatrician or other physician attending the mother or newly born child.

3. Each entity offering individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description shall provide notice to policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence and shall be transmitted at the earliest of:

(1) The next mailing to the policyholder;

(2) The yearly informational packet sent to the policyholder; or

(3) January 1, 1997.

4. Such health care service shall not be subject to any greater deductible or copayment than any other health care service provided by the policy, contract or plan.

5. The department of insurance shall adopt rules and regulations to implement the provisions of this section. The rules and regulations will include language prohibiting the use of incentives or punishments to encourage the mother and infant to leave the hospital before the minimum time has been completed.