Page:United States Statutes at Large Volume 110 Part 4.djvu/90

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110 STAT. 2936 PUBLIC LAW 104-204—SEPT. 26, 1996 "(1) IN GENERAL. —^A group health plan, and a health insurance issuer offering group health insurance coverage, may not— "(A) except as provided in paragraph (2)— "(i) 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 48 hours, or "(ii) 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 96 hours; or "(B) require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under subparagraph (A) (without regard to paragraph (2)). " (2) EXCEPTION.— Paragraph (1)(A) shall not apply in connection with any group health plan or health insurance issuer in any case in which the decision to discharge the mother or her newborn child prior to the expiration of the minimum length of stay otherwise required under paragraph (1)(A) is made by an attending provider in consultation with the mother. "(b) PROHIBITIONS. — ^A group health plan, and a health insurance issuer offering group health insurance coverage in connection with a group health plan, may not— "(1) 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; "(2) provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section; "(3) penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an individual participant or beneficiary in accordance with this section; "(4) provide incentives (monetary or otherwise) to an attending provider to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section; or "(5) subject to subsection (c)(3), restrict benefits for any portion of a period within a hospital length of stay required under subsection (a) in a manner which is less favorable than the benefits provided for any preceding portion of such stay. " (c) RULES OF CONSTRUCTION.— "(1) Nothing in this section shall be construed to require a mother who is a participant or beneficiary— "(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. "(2) This section shall not apply with respect to any group health plan, or any group health insurance coverage offered by a health insurance issuer, which does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child. "(3) Nothing in this section shall be construed as preventing a group health plan or issuer from imposing deductibles, coinsurance, or other cost-sharing in relation to benefits for