BP BHEAD INT S

AN ACT Relating to health insurance benefits following the birth of a child; adding a new section to chapter 41.05 RCW; adding a new section to chapter 48.20 RCW; adding a new section to chapter 48.21 RCW; adding a new section to chapter 48.44 RCW; adding a new section to chapter 48.46 RCW; and creating new sections.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION. Sec. 1. It is the intent of the legislature that the patient's preference and the judgment of the patient's health care provider about appropriate medical care determine the duration and type of care provided to mothers and their newly born children. It is not the intent of the legislature to establish a maximum time period for such care.

NEW SECTION. Sec. 2. A new section is added to chapter 41.05 RCW to read as follows:

(1) If state purchased health care includes coverage for maternity services, the coverage may not be denied for in-patient, postdelivery care to a mother and her newly born child for a period of forty-eight hours or less for a vaginal delivery and ninety-six hours or less for a cesarean section.

(2)(a) State purchased health care that provides coverage for postdelivery care to a mother and her newly born child in the home is not required to provide for a minimum of in-patient care unless such in-patient care is determined to be medically necessary by the health care provider attending the mother or newly born child or is requested by the mother. For the purposes of this section, "health care provider" includes physicians licensed under chapter 18.57 or 18.71 RCW, certified nurse midwives licensed under chapter 18.79 RCW, midwives licensed under chapter 18.50 RCW, and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

(b) Coverage for in-home, postdelivery care may not be denied for three home visits or less if requested by the mother or determined necessary by the health care provider or provider of in-home services and agreed to by the mother. Providers of in-home services may include, but need not be limited to, health care providers as defined in this section, home health agencies licensed under chapter 70.127 RCW, and registered nurses licensed under chapter 18.79 RCW.

NEW SECTION. Sec. 3. A new section is added to chapter 48.20 RCW to read as follows:

(1) If an insurer offers to any individual a health benefit plan that provides coverage for maternity services, the insurer may not deny coverage for in-patient, postdelivery care to a mother and her newly born child for a period of forty-eight hours or less for a vaginal delivery and ninety-six hours or less for a cesarean section.

(2)(a) An insurer that provides coverage for postdelivery care to a mother and her newly born child in the home is not required to provide for a minimum of in-patient care unless such in-patient care is determined to be medically necessary by the health care provider attending the mother or newly born child or is requested by the mother. For the purposes of this section, "health care provider" includes physicians licensed under chapter 18.57 or 18.71 RCW, certified nurse midwives licensed under chapter 18.79 RCW, midwives licensed under chapter 18.50 RCW, and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

NEW SECTION. Sec. 4. A new section is added to chapter 48.21 RCW to read as follows:

(1) If a group disability insurance contract or blanket disability insurance contract, providing health care services, provides coverage for maternity services, the contract may not deny coverage for in-patient, postdelivery care to a mother and her newly born child for a period of forty-eight hours or less for a vaginal delivery and ninety-six hours or less for a cesarean section.

(2)(a) A contract that provides coverage for postdelivery care to a mother and her newly born child in the home is not required to provide for a minimum of in-patient care unless such in-patient care is determined to be medically necessary by the health care provider attending the mother or newly born child or is requested by the mother. For the purposes of this section, "health care provider" includes physicians licensed under chapter 18.57 or 18.71 RCW, certified nurse midwives licensed under chapter 18.79 RCW, midwives licensed under chapter 18.50 RCW, and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

NEW SECTION. Sec. 5. A new section is added to chapter 48.44 RCW to read as follows:

(1) If a health service contractor offers a health benefit plan that provides coverage for maternity services, the contractor may not deny coverage for in-patient, postdelivery care to a mother and her newly born child for a period of forty-eight hours or less for a vaginal delivery and ninety-six hours or less for a cesarean section.

(2)(a) A contractor that provides coverage for postdelivery care to a mother and her newly born child in the home is not required to provide for a minimum of in-patient care unless such in-patient care is determined to be medically necessary by the health care provider attending the mother or newly born child or is requested by the mother. For the purposes of this section, "health care provider" includes physicians licensed under chapter 18.57 or 18.71 RCW, certified nurse midwives licensed under chapter 18.79 RCW, midwives licensed under chapter 18.50 RCW, and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

NEW SECTION. Sec. 6. A new section is added to chapter 48.46 RCW to read as follows:

(1) If a health maintenance organization offers a health benefit plan that provides coverage for maternity services, the health maintenance organization may not deny coverage for in-patient, postdelivery care to a mother and her newly born child for a period of forty-eight hours or less for a vaginal delivery and ninety-six hours or less for a cesarean section.

(2)(a) A health maintenance organization that provides coverage for postdelivery care to a mother and her newly born child in the home is not required to provide for a minimum of in-patient care unless such in-patient care is determined to be medically necessary by the health care provider attending the mother or newly born child or is requested by the mother. For the purposes of this section, "health care provider" includes physicians licensed under chapter 18.57 or 18.71 RCW, certified nurse midwives licensed under chapter 18.79 RCW, midwives licensed under chapter 18.50 RCW, and advanced registered nurse practitioners licensed under chapter 18.79 RCW.

NEW SECTION. Sec. 7. The insurance commissioner shall adopt rules to implement this act.