HOUSE BILL No. 4978


     June 26, 1997, Introduced by Reps. Mans, DeVuyst, LaForge, Dalman, Bankes, Varga, Hale, Dobb, Bodem, Goschka, McBryde, Kilpatrick, Rison, Brater, Schroer, Parks, Hanley, Bogardus, Wojno, Scott, Profit, McNutt and Thomas and referred to the Committee on Insurance.


        A bill to amend 1978 PA 368, entitled

   "Public health code,"

   (MCL 333.1101 to 333.25211) by adding section 21054u.

               THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

 1         SEC. 21054U.  (1) EXCEPT AS OTHERWISE PROVIDED IN

 2    SUBSECTION (2), IN EACH GROUP AND INDIVIDUAL CONTRACT THAT PRO-

 3    VIDES MATERNITY BENEFITS A HEALTH MAINTENANCE ORGANIZATION SHALL

 4    PROVIDE COVERAGE FOR A MINIMUM OF 48 HOURS OF IN-PATIENT HOSPITAL

 5    SERVICES FOLLOWING A VAGINAL DELIVERY AND A MINIMUM OF 96 HOURS

 6    OF IN-PATIENT HOSPITAL SERVICES FOLLOWING A CESAREAN SECTION FOR

 7    A MOTHER AND HER NEWLY BORN CHILD.

 8         (2) SUBSECTION (1) DOES NOT APPLY TO A HEALTH MAINTENANCE

 9    ORGANIZATION CONTRACT THAT PROVIDES HEALTH CARE SERVICES FOR

10    POST-DELIVERY CARE TO A MOTHER AND HER NEWLY BORN CHILD IN THE

11    HOME UNLESS SUCH IN-PATIENT SERVICES ARE REQUESTED BY THE MOTHER


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 1    OR ARE DETERMINED TO BE MEDICALLY NECESSARY BY THE OBSTETRICIAN,

 2    PEDIATRICIAN, OR OTHER PHYSICIAN ATTENDING THE MOTHER OR NEWLY

 3    BORN CHILD.

 4         (3) POST-DELIVERY CARE UNDER SUBSECTION (2) SHALL CONSIST OF

 5    A MINIMUM OF 3 HOME VISITS, IN ACCORDANCE WITH ACCEPTED MATERNAL

 6    AND NEONATAL PHYSICAL ASSESSMENTS, BY A REGISTERED NURSE WITH AT

 7    LEAST 3 YEARS' EXPERIENCE IN COMMUNITY MATERNAL AND CHILD HEALTH

 8    NURSING.  SERVICES PROVIDED BY THE REGISTERED NURSE SHALL

 9    INCLUDE, BUT ARE NOT LIMITED TO, PARENT EDUCATION, ASSISTANCE AND

10    TRAINING IN BREAST OR BOTTLE FEEDING, AND THE PERFORMANCE OF ANY

11    NECESSARY AND APPROPRIATE CLINICAL TESTS.  THE HOME VISITS SHALL

12    BE CONDUCTED WITHIN 24 HOURS, WITHIN 25 TO 48 HOURS, AND WITHIN

13    96 TO 120 HOURS FOLLOWING THE DISCHARGE OF THE MOTHER AND HER

14    NEWLY BORN CHILD.

15         (4) A HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE WRITTEN

16    PROMINENT NOTICE TO ITS ENROLLEES CONCERNING THE COVERAGE

17    REQUIRED BY THIS SECTION AT THE EARLIEST OF THE FOLLOWING:

18         (A) THE FIRST MAILING TO THE ENROLLEE AFTER THE EFFECTIVE

19    DATE OF THIS SECTION.

20         (B) JANUARY 1, 1998.

















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