Requires all insurance policies and health maintenance organization contracts to provide coverage for maternity patients and their newborns for hospital stays of at least 48 hours following childbirth by natural delivery and 96 hours following childbirth by caesarean section; provides similar coverage for patients who are recipients of medicaid.
TITLE OF BILL: An act to amend the social services law, in relation to establishing mandatory minimum medicaid coverage for hospital confinement for childbirth
PURPOSE: To require Medicaid to provide coverage for maternity patients and their newborns for hospital stays of at least 48 hours for natural delivery and 96 hours following caesarean section as is currently provided by private insurers and HMO's.
SUMMARY OF PROVISIONS: Section 1 adds a new subdivision 6-a to Social services Law §365-a to require Medicaid to provide coverage for maternity patients and their newborns for hospital stays of at least 48 hours for natural delivery and 96 hours following caesarean section. It also provides that coverage may be provided for a shorter period of time under certain circumstances outlined in the bill.
Section 2 provides that the act shall take effect 180 days after becoming law.
EXISTING LAW: Chapter 56 of 1996 established mandatory minimum periods of coverage by insurers and HMO's and care by hospitals for maternity stays following childbirth.
JUSTIFICATION: In 1996 the legislature addressed the growing trend of "Revolving Door Deliveries," in which HMOs, insurance companies and hospitals were restricting the length of maternity stay for mothers and newborns following childbirth to 24 hours or less, based upon financial rather than public health considerations. Such early discharges can be detrimental to the health of both mother and newborn, particularly because many conditions which affect newborns, such as jaundice, do not manifest themselves during the first 24 hours of life.
The legislation adopted in 1996 established mandatory minimum periods of coverage for maternity stays following childbirth, however it did not include the same protections for those whose care is paid for through Medicaid. This bill insurers that those covered by Medicaid are not treated differently than those covered by private insurance. It establishes the same mandatory minimum periods of coverage under Medicaid that private insurers are bound to provide.
1999-00: A.7025 S.2801 2001-02: A.751 S.4077 2003-04: A.867 S.651 2005-06: A.2801 A.1061 2007-08: A.3716
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect on the one hundred eightieth day after it shall have become a law.
STATE OF NEW YORK ________________________________________________________________________ 2556 2011-2012 Regular Sessions IN SENATE January 25, 2011 ___________Introduced by Sen. HUNTLEY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the social services law, in relation to establishing mandatory minimum medicaid coverage for hospital confinement for childbirth THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 365-a of the social services law is amended by adding a new subdivision 6-a to read as follows: 6-A. MEDICAID ASSISTANCE SHALL ALSO INCLUDE, FOR MOTHER AND NEWBORN, COVERAGE OF HOSPITAL CONFINEMENT OF AT LEAST FORTY-EIGHT HOURS FOLLOWING A VAGINAL DELIVERY AND AT LEAST NINETY-SIX HOURS FOLLOWING A CAESAREAN SECTION. NOTWITHSTANDING THE ABOVE, A SOCIAL SERVICES DISTRICT MAY PROVIDE COVERAGE FOR A SHORTER PERIOD OF HOSPITAL CONFINEMENT PROVIDED THAT: (A) THE MOTHER IN HER SOLE DISCRETION, EXERCISES THE OPTION TO BE DISCHARGED FROM THE HOSPITAL EARLIER THAN THE TIME PERIOD STATED ABOVE; AND (B) THE TREATING PHYSICIAN, IN ACCORDANCE WITH GENERALLY ACCEPTED MEDICAL STANDARDS, HAS DETERMINED THAT THE MOTHER AND NEWBORN ARE READY FOR DISCHARGE; AND (C) POST-DISCHARGE FOLLOW-UP INCLUDES AT LEAST ONE HOME VISIT PROVIDED WITHIN TWENTY-FOUR HOURS OF DISCHARGE BY A LICENSED HEALTH CARE PROVIDER WHOSE SCOPE OF PRACTICE INCLUDES PROVIDING POSTPARTUM CARE AND SUCH OTHER HOME VISITS AS ARE DEEMED APPROPRIATE. COVERAGE OF SUCH HOME VISITS SHALL INCLUDE, AT A MINIMUM, PARENT EDUCATION, ASSISTANCE AND TRAINING IN BREAST OR BOTTLE FEEDING AND THE PERFORMANCE OF ANY NECES- SARY MATERNAL AND NEWBORN PHYSICAL ASSESSMENTS AND SHALL BE IN ADDITION TO, RATHER THAN IN LIEU OF, ANY HOME HEALTH CARE COVERAGE OTHERWISE AVAILABLE. S 2. This act shall take effect on the one hundred eightieth day after it shall have become a law.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02344-01-1