[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1955 Introduced in House (IH)]







104th CONGRESS
  1st Session
                                H. R. 1955

To amend title I of the Employee Retirement Income Security Act of 1974 
to provide for certain minimum requirements for group health plans with 
                    respect to obstetrical benefits.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 29, 1995

 Mr. DeFazio (for himself, Mr. Miller of California, Mr. Sanders, Mr. 
Waxman, Mr. McDermott, Mr. Dellums, Mr. Owens, Ms. Norton, Ms. Pelosi, 
    Mr. Stark, Mr. Frazer, Mr. Borski, Mr. Serrano, Mr. Matsui, Mr. 
  Oberstar, Mr. Torricelli, Mr. Durbin, Mr. Lipinski, Mr. Evans, Mr. 
Abercrombie, Ms. Slaughter, Ms. Woolsey, and Ms. Furse) introduced the 
  following bill; which was referred to the Committee on Economic and 
                       Educational Opportunities

_______________________________________________________________________

                                 A BILL


 
To amend title I of the Employee Retirement Income Security Act of 1974 
to provide for certain minimum requirements for group health plans with 
                    respect to obstetrical benefits.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Mother-Infant Health Protection Act 
of 1995''.

SEC. 2. GROUP HEALTH PLAN REQUIREMENT.

    Section 609 of the Employee Retirement Income Security Act of 1974 
(29 U.S.C. 1169) is amended--
            (1) by redesignating subsection (e) as subsection (f); and
            (2) by inserting after subsection (d) the following new 
        subsection:
    ``(e) Requirements Relating to Obstetrical Benefits.--
            ``(1) In general.--A group health plan which provides 
        obstetrical benefits shall provide coverage for at least--
                    ``(A) 48 hours of inpatient care following a 
                vaginal delivery, and
                    ``(B) 96 hours of inpatient care following a 
                delivery by caesarean section,
        for the mother and her newborn child in a licensed hospital.
            ``(2) Exception if certain post-delivery care is 
        provided.--
                    ``(A) In general.--Paragraph (1) shall not apply if 
                the plan provides coverage for post-delivery care which 
                satisfies subparagraph (B).
                    ``(B) Requirements.--In order to satisfy this 
                subparagraph, under the terms of the plan providing for 
                coverage for post-delivery care--
                            ``(i) Discharge of the mother and newborn 
                        child may not be required unless they meet the 
                        medical criteria for discharge as enumerated in 
                        the Guidelines for Perinatal Care, as last 
                        issued before January 1, 1996 (or such later 
                        date as may be provided in regulations of the 
                        Secretary), by the American Academy of 
                        Pediatrics and the American College of 
                        Obstetricians and Gynecologists.
                            ``(ii) Discharge of the newborn child may 
                        not be required before opportunity for 
                        appropriate screenings, including PKU, has been 
                        provided. If the screening for PKU is done 
                        prior to 24 hours after birth, the plan must 
                        provide opportunity for a second home visit for 
                        PKU screening within two days after discharge.
                            ``(iii) Discharge must not be before 24 
                        hours of milk feeding.
                            ``(iv) The mother and newborn child must be 
                        allowed at least one overnight stay.
                            ``(v) Appropriate management of the mother 
                        and newborn child must be established in 
                        advance of discharge, including home visits by 
                        qualified health professionals, office visits, 
                        hospital stay, or any combination thereof, 
                        including a home visit with 24 hours after 
                        discharge.
                            ``(vi) Discharge of the mother or newborn 
                        child may not be required without a link to a 
                        continuing care provider.''.

SEC. 3. EFFECTIVE DATE.

    The amendment made by section 2 shall apply with respect to plan 
years beginning at least 6 months after the date of the enactment of 
this Act.
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