[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2854 Introduced in House (IH)]







105th CONGRESS
  1st Session
                                H. R. 2854

To amend the Public Health Service Act, the Employee Retirement Income 
Security Act of 1974, and the Internal Revenue Code of 1986 to require 
 group health plans and group and individual health insurance coverage 
   to provide post-delivery follow-up care for mothers and newborns 
discharged less than 48 hours following a vaginal delivery or less than 
           96 hours following a delivery by cesarean section.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            November 6, 1997

 Mr. LaTourette (for himself, Mr. Miller of California, Mrs. Morella, 
  Mr. Dingell, Mr. Solomon, Ms. DeLauro, Ms. Eddie Bernice Johnson of 
Texas, Mr. McHugh, Mr. Gejdenson, Mrs. Kelly, Mr. Baldacci, Mr. Foley, 
 Mr. Nadler, Mr. Nethercutt, Mr. Frank of Massachusetts, Mr. DeFazio, 
   Mrs. Thurman, Mr. Manton, Mr. Serrano, Ms. Brown of Florida, Ms. 
 Woolsey, Mr. Ackerman, Ms. Rivers, Ms. Lofgren, Mr. Vento, Mr. Evans, 
  Mrs. Maloney of New York, Mr. Gutierrez, Mr. Borski, Mr. Green, and 
Mrs. Mink of Hawaii) introduced the following bill; which was referred 
  to the Committee on Commerce, and in addition to the Committees on 
  Education and the Workforce, and Ways and Means, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act, the Employee Retirement Income 
Security Act of 1974, and the Internal Revenue Code of 1986 to require 
 group health plans and group and individual health insurance coverage 
   to provide post-delivery follow-up care for mothers and newborns 
discharged less than 48 hours following a vaginal delivery or less than 
           96 hours following a delivery by cesarean section.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. REQUIREMENT FOR POST-DELIVERY FOLLOW-UP CARE FOR EARLY 
              HOSPITAL DISCHARGES AFTER CHILDBIRTH.

    (a) Public Health Service Act Amendment.--
            (1) Group health coverage.--Section 2704(a) of the Public 
        Health Service Act (42 U.S.C. 300gg-4(a)) is amended--
                    (A) in paragraph (2), by striking ``Paragraph'' and 
                inserting ``Subject to paragraph (3), paragraph'', and
                    (B) by adding at the end the following new 
                paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
health clinic, a State health department maternity clinic, or another 
setting (which may include a birthing center or an intermediate care 
facility) determined appropriate under regulations promulgated by the 
Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
            (2) Application to individual health insurance coverage.--
        The amendments made by paragraph (1) apply to health insurance 
        coverage in the individual market under section 2751(a) of the 
        Public Health Service Act (42 U.S.C. 300gg-51).
    (b) ERISA Amendments.--Section 711(a) of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185(a)) is amended--
            (1) in paragraph (2), by striking ``Paragraph'' and 
        inserting ``Subject to paragraph (3), paragraph'', and
            (2) by adding at the end the following new paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
                health clinic, a State health department maternity 
                clinic, or another setting (which may include a 
                birthing center or an intermediate care facility) 
                determined appropriate under regulations promulgated by 
                the Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
    (c) Internal Revenue Code of 1986 Amendment.--Section 9811 of the 
Internal Revenue Code of 1986, as inserted by section 1531(a)(4) of the 
Taxpayer Relief Act of 1997, is amended--
            (1) in paragraph (2), by striking ``Paragraph'' and 
        inserting ``Subject to paragraph (3), paragraph'', and
            (2) by adding at the end the following new paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
                health clinic, a State health department maternity 
                clinic, or another setting (which may include a 
                birthing center or an intermediate care facility) 
                determined appropriate under regulations promulgated by 
                the Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
    (d) Effective Dates.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall apply with respect to--
                    (A) group health plans, and health insurance 
                coverage offered in connection with group health plans, 
                for plan years beginning after January 1, 1999; and
                    (B) health insurance coverage offered, sold, 
                issued, renewed, in effect, or operated in the 
                individual market after such date.
            (2) Special rule for collective bargaining agreements.--In 
        the case of a group health plan maintained pursuant to one or 
        more collective bargaining agreements between employee 
        representatives and one or more employers ratified before the 
        date of the enactment of this Act, the amendments made by this 
        section shall not apply to plan years beginning before the 
        later of--
                    (A) the date on which the last of the collective 
                bargaining agreements relating to the plan terminates 
                (determined without regard to any extension thereof 
                agreed to after the date of the enactment of this Act), 
                or
                    (B) January 1, 1999.
        For purposes of subparagraph (A), any plan amendment made 
        pursuant to a collective bargaining agreement relating to the 
        plan which amends the plan solely to conform to any requirement 
        imposed under an amendment made by this Act shall not be 
        treated as a termination of such collective bargaining 
        agreement.
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