X hits on this document

PDF document

[Billing Codes: 4120-01-P; 4830-01-P; 4510-29-P] - page 65 / 83

269 views

0 shares

0 downloads

0 comments

65 / 83

Example 2.

percent

of

the

(i)

cost

of

A group health plan generally

a

hospital

length

of

stay

in

covers 70 connection

with cost

childbirth. of the stay

However, the plan if the participant

plan of the pregnancy hospital the plan may

in advance designate.

of

will cover 80 percent of the or beneficiary notifies the admission and uses whatever

(ii)

In this Example 2, the plan does not violate the rules

of this paragraph (70 percent or 80

(c)(3) because the level of benefits provided percent) is consistent throughout the 48-hour

(or 96-hour) hospital

of

this

section.

(In

length of addition,

stay required the plan does

rules

in

paragraph

(a)(4)

or

paragraph

(b)(2)

under paragraph (a) not violate the of this section.)

(4) Compensation of attending provider. This section does not prevent a group health plan or a health insurance issuer offering group health insurance coverage from negotiating with an attending provider the level and type of compensation for care

furnished in accordance with

  • (b)

    of this section).

  • (d)

    Notice requirement.

this section (including paragraph

Except as provided in paragraph

(d)(4)of this section, a group health plan that provides benefits for hospital lengths of stay in connection with childbirth must meet the following requirements:

(1) Required statement.

The plan document that provides a

description of plan benefits to participants and beneficiaries must disclose information that notifies participants and beneficiaries of their rights under this section.

(2) Disclosure notice.

To meet the disclosure requirement

set forth in paragraph disclosure notice must

(d)(1) of be used:

this

section,

the

following

Statement of Rights under the Newborns’ and Mothers’ Health

Protection Act

65

Document info
Document views269
Page views269
Page last viewedWed Jan 18 20:41:19 UTC 2017
Pages83
Paragraphs2682
Words22647

Comments