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[Billing Codes: 4120-01-P; 4830-01-P; 4510-29-P] - page 20 / 83





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whether the rule raises novel legal or policy issues arising out of the President’s priorities.

The Office of Management and Budget (OMB) has determined this to be a major rule, as

well as an economically significant regulatory action under Section 3(f) of Executive Order

12866. The estimated impact of NMHPA on insured costs is in the range of $130 million to $200

million. The following analysis was conducted by the Departments of Labor and Health and

Human Services.

The interim rules, for the most part, mirror the statutory provisions, which are largely self-

executing. While the interim rules make interpretations or clarifications to some of the statutory

provisions, none of these has a significant economic impact. The effect of the statute is addressed


Effect of the statute

NMHPA was passed in response to a finding by the Congress that group health plans and

health insurance issuers tend to limit benefits for hospital lengths of stay in connection with

childbirth. The main intent of the law was to ensure that adequate care is provided to mothers

and their newborns during the first few critical days following birth. The Congress was concerned

that the decision to discharge the mother and newborn was being driven by the financial

motivations of plans and issuers, rather than the medical interests of the patient.

NMHPA was modeled after guidelines developed by the American College of

Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP).

NMHPA allows the attending provider, in consultation with the mother, to make hospital length

of stay decisions, rather than the plan or issuer. Although mothers and their newborns are not

obligated to stay in the hospital for any period of time following delivery, plans and issuers must


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