illustrated by the following example:
A pregnant woman covered under a group health
plan subject to the requirements of this section goes into labor
and is admitted to a hospital.
She gives birth by
provider for the mother consults with the mother, and the attending provider for the newborn consults with the mother
regarding the newborn. early discharge of both
attending providers authorize
discharged approximately 72 hours after the delivery. pays for the 72-hour hospital stays.
In this Example, the requirements of this paragraph
(a) have newborn.
been satisfied with respect to the mother and the If either is readmitted, the hospital stay for the
readmission is not subject to this section.
(1) With respect to mothers
A group h group heal
Deny a mo eligibili
ealth plan, and a health insurance issuer th insurance coverage, may not ther or her newborn child eligibility or ty to enroll or renew coverage under the terms to avoid the requirements of this section; or ayments (including payments-in-kind) or
to a mother
(ii) Examples illustrated by the group health plan i
to encourage her to accept less than available under this section. The rules of this paragraph (b)(1)
following s subject
In each example,
are the section,
as follows: Example 1.
A group health plan provides benefits for
at least a 48-hour hospital length of stay following a vaginal
If a mother and newborn covered under the plan are
discharged within 24 hours after the waive the copayment and deductible.
this Example 1, because waiver in the nature of a rebate that
of the copayment the mother would