§300gg–51 — Title 42 The Public Health and Welfare | U.S. Code

Summary

Requires health insurance plans sold to individuals to follow most of the same rules that group health plans use for mothers and newborns, except for two specific parts (subsections d and f). Insurers must also give the same kind of notice that group plans give under federal labor law, as if the insurer were a group plan. Those federal rules do not apply if a state law that covers the plan does one of these things: requires at least a 48-hour hospital stay after a normal vaginal birth and at least a 96-hour stay after a cesarean; requires maternity and baby care to follow guidelines from the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or similar professional groups; or leaves the length of stay up to the mother’s attending clinician in consultation with her. A related federal rule about preemption does not override those state laws.

Title 42, §300gg–51

The Public Health and Welfare — Source: USLM XML via OLRC

(a)The provisions of section 2704 11 See References in Text note below. (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)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)(1)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)section 300gg–62(a) of this title shall not be construed as superseding a State law described in paragraph (1).

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 2704, referred to in subsec. (a), is a reference to section 2704 of act

July 1, 1944. section 2704, which was classified to section 300gg–4 of this title, was renumbered section 2725, and amended by Pub. L. 111–148, title I, §§ 1001(2), 1563(c)(3), formerly § 1562(c)(3), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 265, 911, and was transferred to section 300gg–25 of this title. A new section 2704 of act

July 1, 1944, related to prohibition of preexisting condition exclusions or other discrimination based on health status, was added, effective for plan years beginning on or after Jan. 1, 2014, with certain exceptions, and amended, by Pub. L. 111–148, title I, §§ 1201(2), 1563(c)(1), formerly § 1562(c)(1), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 154, 264, 911, and is classified to section 300gg–3 of this title. section 300gg–23(d)(1) of this title, referred to in subsec. (c)(1), was in the original “section 2723(d)(1)”, and was translated as meaning section 2724(d)(1) of act

July 1, 1944, to reflect the probable intent of Congress and the renumbering of section 2723 as 2724 by Pub. L. 111–148, title I, §§ 1001(4), 1563(c)(14)(B), formerly § 1562(c)(14)(B), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 130, 269, 911.

Statutory Notes and Related Subsidiaries

Effective Date

Section applicable to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after Jan. 1, 1998, see section 605(c) of Pub. L. 104–204, set out as an

Effective Date

of 1996 Amendment note under section 300gg–44 of this title.

§300gg–51 Standards relating to benefits for mothers and newborns

Summary

Title 42, §300gg–51

Notes & Related Subsidiaries

Editorial Notes

References in Text

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Citations & Metadata