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42 U.S.C. § 300gg–51Standards relating to benefits for mothers and newborns

submitted 82 years ago by Pub. L. 104-204 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 304 words · no verdicts yet

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This law extends federal hospital-stay protections to individual health insurance. New mothers and babies get the same rights as under group plans. Insurers must give enrollees the required notice, but states with their own qualifying maternity laws are exempt.

(a) In general: The requirements of section 2704 (except subsections (d) and (f)) — the federal minimum hospital-stay rules for childbirth — apply to health coverage an insurer sells in the individual market the same way they apply to coverage sold in connection with a group health plan in the small or large group market. (b) Notice requirement: An insurer under this part must comply with the notice requirement in section 1185(d) of title 29 for the (a) requirements, as if that section applied to the insurer and the insurer were a group health plan. (c) Preemption; exception for health insurance coverage in certain States (1) In general: This section's requirements don't apply to coverage in a state that has its own law regulating that coverage and that does one of the following: (A) requires at least a 48-hour hospital stay after a normal vaginal delivery and at least a 96-hour stay after a cesarean section; (B) requires maternity and pediatric care to follow guidelines set by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or another established professional medical association; or (C) leaves the length of the maternity hospital stay to the decision of the attending provider, made together with the mother. (2) Construction: The general preemption rule in section 300gg–62(a) does not override a state law described in paragraph (1).
the actual law source: uscode.house.gov ↗public domain
(a) In general

The provisions of section 2704 1 (other than subsections (d) and (f)) shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as it applies to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.

(b) Notice requirement

A health insurance issuer under this part shall comply with the notice requirement under section 1185(d) of title 29 with respect to the requirements referred to in subsection (a) as if such section applied to such issuer and such issuer were a group health plan.

(c) Preemption; exception for health insurance coverage in certain States
(1) In general

The requirements of this section shall not apply with respect to health insurance coverage if there is a State law (as defined in section 300gg–23(d)(1) 1 of this title) for a State that regulates such coverage that is described in any of the following subparagraphs:

(A)

Such State law requires such coverage to provide for at least a 48-hour hospital length of stay following a normal vaginal delivery and at least a 96-hour hospital length of stay following a cesarean section.

(B)

Such State law requires such coverage to provide for maternity and pediatric care in accordance with guidelines established by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or other established professional medical associations.

(C)

Such State law requires, in connection with such coverage for maternity care, that the hospital length of stay for such care is left to the decision of (or required to be made by) the attending provider in consultation with the mother.

(2) Construction

Section 300gg–62(a) of this title shall not be construed as superseding a State law described in paragraph (1).

Source credit: (July 1, 1944, ch. 373, title XXVII, § 2751, as added Pub. L. 104–204, title VI, § 605(a)(4), Sept. 26, 1996, 110 Stat. 2941.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 104-204 · 110 Stat. 2941

A history note hasn’t been published yet. The record shows enactment by Pub. L. 104-204 on 1944-07-01.

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