HomeMy WebLinkAboutNewborn and Womens Health NoticeNewborns Act Disclosure
Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hos-
pital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a
vaginal delivery, or less than 96 hours following a cesarean section.
However, Federal law generally does not prohibit the mother's or newborn's attending provider, after consulting
with the mother, from discharging the mother or her newborn earlier than 48 hours or 96 hours as applicable). In
any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan
or the insurance issuer for prescribing a length of stay not in excess of 48 hours or 96 hours).
The Women's Health and Cancer Rights Act
The Women's Health and Cancer Rights Act of 1998 requires group health plans that provide coverage for a mas-
tectomy to provide coverage for certain reconstructive services. This law also requires that written notice of the
availability of the coverage be delivered to all plan participants upon enrollment and annually thereafter. This lan-
guage serves to fulfill that requirement for this year. These services include:
® Reconstruction of the breast upon which the mastectomy has been performed;
® Surgery/reconstruction of the other breast to produce a symmetrical appearance;
® Prostheses; and
♦ Treatment for physical complications during all stages of mastectomy, including lymph edemas.
In addition, the plan may not:
® Interfere with a participant's rights under the plan to avoid these requirements; or
® Offer inducements to the healthcare provider, or assess penalties against the provider, in an attempt to
interfere with the requirements of the law.
However, the plan may apply deductibles, coinsurance, and co -payments consistent with other coverage provided
by the plan.
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