Federal Law > Managing Employees > Newborn's/Mother's Health Protection

Newborn's/Mother's Health Protection

 

The Newborn's and Mothers' Health Protection Act of 1996 (NMHPA) was signed into law on September 26, 1996. The law includes important new protections for mothers and their newborn children with regard to the length of hospital stays following the birth of a child. The following information is intended to provide general guidance on frequently asked questions about NMHPA.


How does the Newborns' and Mothers' Health Protection Act affect my health care benefits? One of the most important changes provided under the newborns' and Mothers' Health Protection Act (NMHPA) relates to the amount of time a mother and newborn child can spend in the hospital in connection with the birth of a child. Under NMHPA, group health plans, insurance companies and health maintenance organizations (HMOs) offering health coverage for hospital stays in connection with the birth of a child must provide health coverage for a minimum period of time.

For example, NMHPA provides that coverage for a hospital stay following a normal vaginal delivery may generally not be limited to less than 48 hours for both the mother and newborn child. Health coverage for a hospital stay in connection with childbirth following a cesarean section may generally not be limited to less than 96 hours for both the mother and newborn child.

Do all health plans have to provide minimum hospital stays in connection with childbirth? No. NMHPA's requirements only apply to group health plans, insurance companies and HMOs that choose to provide insurance coverage for a hospital stay in connection with childbirth. NMHPA does not require group health plans, insurance companies or HMOs to provide coverage for hospital stays in connection with the birth of a child. It is important, therefore, to review the terms of your health care plan to understand if the changes in NMHPA affect you.

May group health plans, insurance companies or HMOs impose deductibles or other cost-sharing provisions for hospital stays in connection with childbirth? Yes. NMHPA does not prevent a group health plan, insurance company or HMO from imposing deductibles, coinsurance or other cost-sharing measures for health benefits relating to hospital stays in connection with childbirth as long as such cost-sharing measures are not greater than those imposed on any preceding portion of the hospital stay. For example, if you are required to pay a $50 co-payment for each day you spend in the hospital preceding childbirth you may not be charged a higher co-payment, or offered few benefits, for the time NMHPA allows you to spend in the hospital following childbirth (48 to 96 hours).

When will the changes in NMHPA affect my health plan? The requirements under NMHPA apply to group health plans, insurance companies and HMOs for plan years beginning on or after January 1, 1998. It is important, therefore, for you to review the terms of your health plan to find out when the changes required by NMHPA will affect you. NMHPA does not have a separate effective date for collectively bargained plans.

SOURCES

  1. This chapter is adapted from Questions & Answers: Recent Changes in Health Care Law, U.S. Department of Labor, Pension and Welfare Benefits Administration, April, 1997.
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