(A) continued avoid the
Deny a mother or her newborn child eligibility or eligibility to enroll in or renew coverage solely requirements of this section; or
Provide payments (including payments-in-kind) or
to encourage her to accept less available under this section.
paragraph (b)(1) In each example,
to a mother
The rules of this
follows: Example 1.
An issuer provides benefits for at least a
48-hour hospital length of stay following a vaginal delivery. a mother and newborn covered under a policy issued in the individual market are discharged within 24 hours after the delivery, the issuer will waive the copayment and deductible.
this Example 1, because waiver in the nature of a rebate that
of the copayment the mother would
receive if she and prohibited by this violates paragraph
her newborn remained in the hospital, it is
copayment or deductible is required for the first portion stay and a double copayment and a deductible are required second portion of the stay.)
of the for the
Example 2. 48-hour hospital the event that a
(i) An issuer length of stay mother and her
provides benefits for at least following a vaginal delivery. newborn are discharged earlier
the mother in accordance with the requirements of (a)(5) of this section, the issuer provides for a
by a nurse within 48 hours after certain services that the mother receive in the hospital.
discharges to provide her newborn would otherwise
In this Example 2, because the follow-up visit does
not provide any services beyond what the mother would receive in the hospital, coverage for the is not prohibited by this paragraph (b)(1).
and her newborn follow-up visit