CHAPTER 24. MINIMUM MATERNITY BENEFITS
IC 27-8-24
Chapter 24. Minimum Maternity Benefits
IC 27-8-24-1
Applicability of chapter
Sec. 1. This chapter applies to:
(1) every policy of accident and sickness insurance (as defined
in IC 27-8-5-1), whether written on an individual basis, a group
basis, a franchise basis, or a blanket basis; and
(2) every group contract (as defined in IC 27-13-1-16) or
individual contract (as defined in IC 27-13-1-21) through which
a health maintenance organization furnishes health care
services;
that is issued, delivered, executed, or renewed in Indiana and that
provides maternity benefits.
As added by P.L.194-1996, SEC.1.
IC 27-8-24-2
"At-home postdelivery care" defined
Sec. 2. As used in this chapter, "at-home postdelivery care" refers
to health care provided to a woman at her residence by a physician
licensed under IC 25-22.5 or a registered nurse or an advanced
practice nurse licensed under IC 25-23 whose scope of practice
includes providing postpartum care in the area of maternal and child
health care. The health care services provided must include, at a
minimum:
(1) parent education;
(2) assistance and training in breast or bottle feeding; and
(3) performance of any maternal and neonatal tests routinely
performed during the usual course of inpatient care for the
woman or her newborn child, including the collection of an
adequate sample for the hereditary and metabolic newborn
screening.
As added by P.L.194-1996, SEC.1.
IC 27-8-24-3
"Maternity benefits" defined
Sec. 3. As used in this chapter, "maternity benefits" refers to the
provision of health care to a woman before, during, and after delivery
of a child, including physician, hospital, laboratory, and ultrasound
services.
As added by P.L.194-1996, SEC.1.
IC 27-8-24-4
Postpartum hospital stay; HIV testing of newborns; payment
Sec. 4. (a) Except as provided in section 5 of this chapter, every
policy or group contract that provides maternity benefits must
provide minimum benefits to a mother and her newborn child that
cover:
(1) a minimum length of postpartum stay at a hospital licensed
under IC 16-21 that is consistent with the minimum postpartum
hospital stay recommended by the American Academy of
Pediatrics and the American College of Obstetricians and
Gynecologists in their Guidelines for Perinatal Care;
(2) the examinations to the newborn child required under
IC 16-41-17-2; and
(3) the testing of the newborn child required under
IC 16-41-6-4.
(b) Payment to a hospital for a test required under IC 16-41-6-4
must be in an amount equal to the hospital's actual cost of performing
the test.
As added by P.L.194-1996, SEC.1. Amended by P.L.91-1999, SEC.5;
P.L.237-2003, SEC.17.
IC 27-8-24-5
Conditions warranting shorter period of inpatient care; at-home
postdelivery care visit
Sec. 5. (a) If the patients' attending physician determines further
inpatient care is not necessary for the mother or newborn child, a
policy or group contract that provides maternity benefits under this
chapter may provide under the policy or group contract a shorter
length of postpartum hospital stay than the period under section 4 of
this chapter if all the following conditions are met:
(1) in the patients' attending physician's opinion the newborn
meets the criteria for medical stability in the Guidelines for
Perinatal Care prepared by the American Academy of Pediatrics
and the American College of Obstetricians and Gynecologists
that determine the appropriate length of stay based upon
evaluation of:
(A) the antepartum, intrapartum, and postpartum course of
the mother and infant;
(B) the gestational stage, birth weight, and clinical condition
of the infant;
(C) the demonstrated ability of the mother to care for the
infant after discharge; and
(D) the availability of postdischarge follow-up to verify the
condition of the infant after discharge; and
(2) the policy or contract authorizes for the mother and the
newborn one (1) at-home postdelivery care visit described in
subsection (b).
(b) The at-home postdelivery care visit shall be conducted not
later than forty-eight (48) hours following the discharge of the
woman and her newborn child from a licensed hospital. However, at
the mother's discretion, the visit may occur at the facility of the
provider subject to the terms of the policy or group contract.
(c) The provider of the policy or group contract described in this
chapter shall provide notice to each enrollee under the policy or
group contract regarding the coverage provided under this chapter.
As added by P.L.194-1996, SEC.1. Amended by P.L.2-1997, SEC.66.