Senate Bill NO. 2565

By Senator(s) Nunnelee, Ross

SECTION *. The following section shall be codified in Chapter 15 of Title 25, Mississippi Code of 1972:

(1) The State and School Employees Health Insurance Plan shall not, except as provided in subsection (2) of this section:

(a) Restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child following a normal vaginal delivery to less than forty-eight (48) hours; or

(b) Restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child following a Cesarean section to less than ninety-six (96) hours; or

(c) Require that a provider obtain authorization from the health insurance issuer for prescribing any length of stay required in this subsection (1).

(2) This section shall not apply in any case in which the decision to discharge the mother or her newborn child before the expiration of the minimum length of stay otherwise required under subsection (1) of this section is made by an attending provider in consultation with the mother.

(3) The State and School Employees Health Insurance Plan shall not:

(a) Deny to the mother or her newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan solely for the purpose of avoiding the requirements of this section;

(b) Provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section;

(c) Penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an enrollee in accordance with this section;

(d) Provide incentives, monetary or otherwise, to an attending provider to induce such provider to provide care to an insured or enrollee in a manner inconsistent with this section; or

(e) Subject to subsection (6) of this section, restrict benefits for any portion of a period within a hospital length of stay required under subsection (1) of this section in a manner which is less favorable than the benefits provided for any preceding portion of such stay.

(4) Nothing in this section shall be construed to require a mother who is an enrollee:

(a) To give birth in a hospital; or

(b) To stay in the hospital for a fixed period of time following the birth of her child.

(5) This section shall not apply with respect to any health insurance coverage offered by the plan which does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child.

(6) Nothing in this section shall be construed as preventing the plan from imposing deductibles, coinsurance or other cost-sharing in relation to benefits for hospital lengths of stay in connection with childbirth for a mother or newborn child, except that such coinsurance or other cost-sharing for any portion of a period within a hospital length of stay required under subsection (1) of this section may not be greater than such coinsurance or cost-sharing for any preceding portion of such stay.

(7) The State and School Employees Health Insurance Plan shall provide notice to each enrollee regarding the coverage required by this section. Such notice shall be in writing and prominently positioned in any literature or correspondence made available or distributed by the plan and shall be transmitted to the named enrollee not later than July 1, 2000.

(8) Nothing in this section shall be construed to prevent the State and School Employee Health Insurance Plan from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section.