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
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