It is enacted by the General Assembly as follows:

SECTION 1. Purpose.

WHEREAS, The first few days after birth are critical for infant health and later child development; and

WHEREAS, The period of labor, delivery, and postpartum recovery is one of stress, adjustment, and new nurturing responsibilities for mothers; and

WHEREAS, Rhode Island has developed a statewide system of newborn screening and follow-up to detect and manage phenylkatonuria, hypothyroidism, hemoglobinopathies, hearing deficits and other major threats to child health and development; and

WHEREAS, the recognition and management of mothers and infants health needs should be controlled by the mother and her chosen health care providers; and

WHEREAS, Five thousand (5,000) to eight thousand (8,000) new Rhode Island mothers are expected to be discharged less than twenty-four (24) hours after delivery in 1995, at a saving of one thousand dollars ($1,000) to two thousand dollars ($2,000) per delivery; and

WHEREAS, Substantial numbers of vulnerable new parents and infants are not receiving the prenatal preparation, follow-up, support and repeat testing needed to prevent serious health and development problems; and

WHEREAS, Prematurity and low birth weight are major factors in infant mortality and often a major challenge for new parents; and

WHEREAS, The state children's system plan calls for universal newborn screening, and the provision of home visiting and follow-up of all mothers and infants with medical, social, and environmental risk factors; and

WHEREAS, The guidelines for perinatal care published by the American College of Obstetrics and Gynecology recommend a hospital stay of forty-eight (48) hours to ninety-six (96) hours after childbirth, unless a complete system of prenatal preparation, education, home visits, and follow-up is in place for those who chose earlier discharge; and

WHEREAS, It is the intent of the General Assembly to prevent illness and developmental delays and to support the state system of home visiting, parent education, assistance in training in breast or bottle feeding, and community supports for vulnerable new parents, in part by reinvestment of some of the savings from shortened maternity hospitalization; and now therefore,

The General Assembly enacts this legislation to mandate health insurers to provide coverage in their policies which will provide for post partum hospital care of a minimum of forty-eight (48) hours after a vaginal birth and ninety-six (96) hours after a Caesarean section.

SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section:

{ADD 27-18-33.1. Insurance coverage for post-partum hospital stays. -- Every individual or group hospital or medical services plan contract delivered, issued for delivery, as renewed in this state on or after September 1, 1996 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 Caesarean 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.

For the purposes of this section, attending health care provider shall include the attending obstetrician, pediatrician, family practitioner, general practitioner or certified nurse midwife attending the mother and newly born child.

Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of health, which have been promulgated pursuant to chapter 23-17.12. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other health care provider who orders care consistent with the provisions of this section. ADD}

SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:

{ADD 27-19-23.1. Insurance coverage for post-partum hospital stays. -- Every individual or group hospital or medical services plan contract delivered, issued for delivery, as renewed in this state on or after September 1, 1996 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 Caesarean 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.

For the purposes of this section, attending health care provider shall include the attending obstetrician, pediatrician, family practitioner, general practitioner or certified nurse midwife attending the mother and newly born child.

Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of health, which have been promulgated pursuant to chapter 23-17.12. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other health care provider who orders care consistent with the provisions of this section. ADD}

SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:

{ADD 27-20-17.1. Insurance coverage for post-partum hospital stays. -- Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after September 1, 1996 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 Caesarean 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.

For the purposes of this section, attending health care provider shall include the attending obstetrician, pediatrician, family practitioner, general practitioner or certified nurse midwife attending the mother and newly born child.

Any subscriber who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of health, which have been promulgated pursuant to chapter 23-17.12. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other health care provider who orders care consistent with the provisions of this section. ADD}

SECTION 5. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:

{ADD 27-41-30.1. Post-partum hospital stays. -- Every individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state on or after September 1, 1996 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 Caesarean 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.

For the purposes of this section, attending health care provider shall include the attending obstetrician, pediatrician, family practitioner, general practitioner or certified nurse midwife attending the mother and newly born child.

Any member who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of health, which have been promulgated pursuant to chapter 23-17.12. No policy or plan covered under this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other health care provider who orders care consistent with the provisions of this section. ADD}

SECTION 6. This act shall take effect upon passage.