PRINTER'S NO. 2440

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 1977 Session of 1995


        INTRODUCED BY MICOZZIE, SCHRODER, E. Z. TAYLOR, COLAIZZO, BARD,
           BOSCOLA, BROWN, CARONE, L. I. COHEN, DURHAM, FARMER, HARHART,
           LAUGHLIN, LEDERER, MAJOR, MILLER, MUNDY, RUBLEY, RUDY,
           SHEEHAN, TRUE, VANCE, ADOLPH, CIVERA, FLICK, GANNON, LAWLESS,
           RAYMOND, BUXTON, DEMPSEY, FICHTER, GLADECK, SATHER, STEIL,
           GEIST, STERN AND HERSHEY, SEPTEMBER 18, 1995

        REFERRED TO COMMITTEE ON INSURANCE, SEPTEMBER 18, 1995

                                     AN ACT

     1  Providing for certain health insurance benefits to aid the
     2     health and well-being of mother and child following the birth
     3     of a child.

     4     The General Assembly of the Commonwealth of Pennsylvania
     5  hereby enacts as follows:
     6  Section 1.  Short title.
     7     This act shall be known and may be cited as the Mother and
     8  Infant Health Security Act.
     9  Section 2.  Health benefit contract.
    10     Every individual or group health benefits contract that
    11  provides maternity benefits and is delivered, issued, executed
    12  or renewed in this Commonwealth pursuant to the act of May 18,
    13  1976 (P.L.123, No.54), known as the Individual Accident and
    14  Sickness Insurance Minimum Standards Act, or approved for
    15  issuance or renewal in this Commonwealth by the Insurance
    16  Commissioner on or after the effective date of this act shall


     1  provide coverage for a minimum of 48 hours of inpatient care,
     2  excluding the day of delivery, for the mother and the newborn
     3  after childbirth, except as otherwise provided in this act.
     4  Section 3.  Utilization review standards.
     5     (a)  Length of stay.--A plan for utilization review
     6  standards, including those standards applied to determine length
     7  of stay and inpatient services related to maternity and newborn
     8  care, shall be applied in accordance with the medical criteria
     9  outlined in the most current version of the "Guidelines for
    10  Perinatal Care" prepared by the American Academy of Pediatrics
    11  and the American College of Obstetricians and Gynecologists.
    12     (b)  Medical stability.--A plan may provide coverage for a
    13  shorter length of hospital inpatient stay for services related
    14  to maternity and newborn care provided that the mother and the
    15  newborn meet the criteria for medical stability in the
    16  "Guidelines for Perinatal Care" and the plan provides coverage
    17  for an initial postpartum home visit for the mother and child.
    18  Section 4.  Effective date.
    19     This act shall take effect in 60 days.








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