To amend chapter 376, RSMo, by adding one new section relating to certain health insurance benefits following the birth of a child.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI,

AS FOLLOWS:

Section A. Chapter 376, RSMo, is amended by adding one new section, to be known as section 376.1210, to read as follows:

376.1210. 1. This act shall be known as the "Post- Delivery Care for Mothers and Newborns Act".

2. Each entity offering individual and group health insurance policies providing coverage on an expense- incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self- insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description, that are delivered, issued for delivery, continued or renewed in this state on or after January 1, 1997, shall provide coverage for in-home care provided by those licensed pursuant to section 334.260, RSMo, certified nurse midwives and certified professional midwives, and coverage for a minimum of forty-eight hours of in- patient care following a vaginal delivery and a minimum of ninety-six hours of in- patient care following a cesarean section for a mother and her newly born child in a health care facility licensed pursuant to chapter 197, RSMo.

3. Notwithstanding the provisions of subsection 2 of this section, any entity offering individual and group health insurance policies providing coverage on an expense- incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self- insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description may authorize a shorter length of hospital stay for services related to maternity and newborn care if:

(1) The newborn meets the criteria for medical stability outlined in the most current version of the "Guidelines for Perinatal Care" prepared by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists;< p> (2) A shorter hospital stay meets with the approval of the attending physician; and

(3) The entity providing the individual or group health insurance policy provides coverage for post-discharge care to the mother and her newborn upon the orders of the attending physician. Post-discharge care shall consist of a minimum of two visits in accordance with accepted maternal and neonatal physical assessments, by a registered professional nurse with experience in maternal and child health nursing. Services provided shall include, but not be limited to, physical assessment of the newborn, parent education, assistance and training in breast or bottle feeding, assurance that a satisfactory metabolic specimen is accepted by the state laboratory, assessment of 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 national pediatric, obstetric and nursing professional organizations. Post-discharge visits shall be on a schedule as determined by the attending physician. For the purposes of this section, "attending physician" shall include the attending obstetrician, pediatrician or other physician attending the mother or newly born child.

4. Each entity offering individual and group health insurance policies providing coverage on an expense- incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self- insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description shall provide notice to policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence and shall be transmitted at the earliest of:

(1) The next mailing to the policyholder;

(2) The yearly informational packet sent to the policyholder; or

(3) January 1, 1997.

5. Such health care service shall not be subject to any greater deductible or copayment than any other health care service provided by the policy, contract or plan.

6. The department of insurance shall adopt rules and regulations to implement the provisions of this section. The rules and regulations will include language prohibiting the use of incentives or punishments to:

(1) Encourage the mother and infant to leave the hospital before the minimum time has been completed; or

(2) Encourage any attending provider to release the mother and infant before the minimum time has been completed.< p> 7. Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance policies.