consultation with the mother rather than by contract or agreement between the hospital and the insurer. These decisions must be based on accepted medical practice. RCW 48.43.115 Plan may not deny covered, eligible services for follow-up care, (3)(d) including in-person care, as ordered by the attending provider in consultation with the mother. Coverage for providers of follow-up services must include, but need not be limited to, attending providers, home health agencies licensed under chapter RCW, and registered nurses licensed under chapter RCW. 48.43.115 This section does not require attending providers to authorize care (3)(e) they believe to be medically unnecessary. Maternity and Length of RCW 48.43.115 The plan must provide notice that the health care provider in Newborn Stay (3) and (5) consultation with the mother will determine the care and length Services (EHB) (“Erin Act”); 42 of hospital stay. (Cont’d) USC 300gg-51 If length of stay guideline is stated it must be no less than: 48-hour normal birth/96 caesarian section birth. The plan cannot restrict follow-up care when ordered by the attending provider in consultation with the mother. (“Newborns’ and Mothers’ Health Protection Act of 1996”) Dependent WAC Plan must include maternity coverage and newborn delivery for Daughter dependent daughters on the same basis as the EHB-benchmark Coverage WAC plan. Religious 45 CFR and An “objecting organization” is eligible for a exemption religious §147.132(a)(1) Exception from providing contraceptive coverage if it objects: to 45 CFR to its establishing, maintaining, providing, offering, or arranging §147.132(a)(2) (as applicable) coverage, payments, or a that provides coverage
consultation with the mother rather than by contract or agreement between the hospital and the insurer. These decisions must be based on accepted medical practice. RCW 48.43.115 (3)(d) Plan may not deny covered, eligible services for follow-up care, including in-person care, as ordered by the attending provider in consultation with the mother. Coverage for providers of follow-up services must include, but need not be limited to, attending providers, home health agencies licensed under chapter RCW, and registered nurses licensed under chapter RCW. 48.43.115 (3)(e) This section does not require attending providers to authorize care they believe to be medically unnecessary. Maternity and Newborn Services (EHB) (Cont’d) Length of Stay RCW 48.43.115 (3) and (5) (“Erin Act”); 42 USC 300gg-51 The plan must provide notice that the health care provider in consultation with the mother will determine the care and length of hospital stay. If length of stay guideline is stated it must be no less than: 48-hour normal birth/96 caesarian section birth. The plan cannot restrict follow-up care when ordered by the attending provider in consultation with the mother. (“Newborns’ and Mothers’ Health Protection Act of 1996”) Dependent Daughter Coverage WAC WAC Plan must include maternity coverage and newborn delivery for dependent daughters on the same basis as the EHB-benchmark plan. Religious and Exception to 45 CFR §147.132(a)(1) An “objecting organization” is eligible for a religious exemption from providing contraceptive coverage if it objects: 45 CFR §147.132(a)(2) to its establishing, maintaining, providing, offering, or arranging (as applicable) coverage, payments, or a that provides coverage
cl-forms-19-hmo-sg-analyst-checklist.docx