PRIOR PRINTER'S NOS. 2440, 3180 PRINTER'S NO. 3327
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, HERSHEY, STEELMAN, YOUNGBLOOD, NICKOL,
GODSHALL, COLAFELLA, CLYMER, HERMAN, PHILLIPS, FAJT, JOSEPHS
AND GORDNER, SEPTEMBER 18, 1995
AS RE-REPORTED FROM COMMITTEE ON APPROPRIATIONS, HOUSE OF
REPRESENTATIVES, AS AMENDED, MARCH 25, 1996
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. Definitions.
10 The following words and phrases when used in this act shall
11 have the meanings given to them in this section unless the
12 context clearly indicates otherwise:
13 "Health insurance policy." Any individual or group health
14 insurance policy, contract or plan which provides medical or
15 health care coverage by any health care facility or licensed
1 health care provider on an expense-incurred service or prepaid
2 basis and which is offered by or is governed under any of the
3 following:
4 Act of May 17, 1921 (P.L.682, No.284), known as The
5 Insurance Company Law of 1921.
6 Subarticle (f) of Article IV of the act of June 13, 1967
7 (P.L.31, No.21), known as the Public Welfare Code.
8 Act of December 29, 1972 (P.L.1701, No.364), known as the
9 Health Maintenance Organization Act.
10 Act of May 18, 1976 (P.L.123, No.54), known as the
11 Individual Accident and Sickness Insurance Minimum Standards
12 Act.
13 Act of December 14, 1992 (P.L.835, No.134), known as the
14 Fraternal Benefit Societies Code.
15 A nonprofit corporation subject to 40 Pa.C.S. Chs. 61
16 (relating to hospital plan corporations) and 63 (relating to
17 professional health services plan corporations).
18 Section 3. Post partum coverage standards.
19 (a) General rule.--Every health insurance policy that
20 provides maternity benefits and is delivered, issued, executed
21 or renewed in this Commonwealth on or after the effective date
22 of this act shall provide coverage for a minimum of 48 hours of
23 inpatient care following normal vaginal delivery and 96 hours of
24 inpatient care following Caesarean delivery.
25 (b) Other lengths of stay.--In addition to the coverage in
26 subsection (a), a health insurance policy may also provide for a
27 shorter length of stay, but only if the treating or attending
28 physician determines that the mother and newborn meet medical
29 criteria for safe discharge contained within guidelines
30 developed by or in cooperation with treating physicians which
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1 recognize treatment standards, including SUCH AS those of the <--
2 American Academy of Pediatrics and the American College of
3 Obstetricians and Gynecologists, that determine appropriate
4 length of stay based upon, but not limited to, the following:
5 the evaluation of the antepartum, intrapartum and post partum
6 course of the mother and infant; the gestational stage, birth
7 weight and clinical condition of the infant; the demonstrated
8 ability of the mother to care for the infant postdischarge and
9 the availability of the postdischarge follow-up care to verify
10 the condition of the infant and mother within 48 hours after
11 discharge.
12 (c) Home health care visits.--The health insurance policy
13 shall provide coverage for AT LEAST ONE home health care visits, <--
14 in accordance with the recommendations of the treating
15 physician, VISIT WITHIN 48 HOURS AFTER DISCHARGE WHEN DISCHARGE <--
16 OCCURS PRIOR TO THE TIMES SET FORTH IN SUBSECTION (A). SUCH
17 VISITS SHALL BE MADE by a licensed health care provider whose
18 scope of practice includes post partum care. Home health care
19 visits shall include, at a minimum, parent education, assistance <--
20 and training in breast and bottle feeding, infant screening and
21 clinical tests and the performance of any necessary maternal and
22 neonatal physical assessments. At the mother's sole discretion,
23 any visits may occur at the facility of the provider.
24 Section 4. Effective date.
25 This act shall take effect in 60 days.
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