Sec. 38a-530c. Mandatory coverage for maternity care. Notice required.
Sec. 38a-530c. Mandatory coverage for maternity care. Notice required. (a)
As used in this section, "carrier" means each insurer, health care center, hospital and
medical service corporation, or other entity delivering, issuing for delivery, renewing
or amending any group health insurance policy in this state on or after October 1, 1996,
providing coverage of the type specified in subdivisions (1), (2), (4), (6), (10), (11) and
(12) of section 38a-469.
(b) Each group insurance carrier that offers maternity benefits shall provide coverage of a minimum of forty-eight hours of inpatient care for a mother and her newborn
infant following a vaginal delivery and a minimum of ninety-six hours of inpatient care
for a mother and her newborn infant following a caesarean delivery. The time periods
shall commence at the time of delivery.
(c) Any decision to shorten the length of inpatient stay to less than that provided
under subsection (b) of this section shall be made by the attending health care providers
after conferring with the mother.
(d) If a mother and newborn are discharged pursuant to subsection (c) of this section,
prior to the inpatient length of stay provided under subsection (b) of this section, coverage shall be provided for a follow-up visit within forty-eight hours of discharge and an
additional follow-up visit within seven days of discharge. Such follow-up services shall
include, but not be limited to, physical assessment of the newborn, parent education,
assistance and training in breast or bottle feeding, assessment of the home support system
and the performance of any medically necessary and appropriate clinical tests. Such
services shall be consistent with protocols and guidelines developed by attending providers or by national pediatric, obstetric and nursing professional organizations for these
services and shall be provided by qualified health care personnel trained in postpartum
maternal and newborn pediatric care.
(e) Each group insurance carrier shall provide notice to policyholders regarding the
coverage required under this section. The notice shall be in writing and shall be transmitted at the earliest of either the next mailing to the policyholder, the yearly summary of
benefits sent to the policyholder or January 1, 1997.
(P.A. 96-177, S. 2, 6.)
History: P.A. 96-177 effective May 24, 1996.
See Sec. 38a-503c for similar provisions re individual policies.