514C.12 Postdelivery benefits and care.
1. Notwithstanding section 514C.6, a person who provides an individual or group policy of accident or health insurance or individual or group hospital or health care service contract issued pursuant to chapter 509, 509A, 514, or 514A or an individual or group health maintenance organization contract issued and regulated under chapter 514B, which is delivered, amended, or renewed on or after July 1, 1996, and which provides maternity benefits, which are not limited to complications of pregnancy, or newborn care benefits, shall not terminate inpatient benefits or require discharge of a mother or the newborn from a hospital following delivery earlier than determined to be medically appropriate by the attending physician after consultation with the mother and in accordance with guidelines adopted by rule by the commissioner. The guidelines adopted by rule shall be consistent with or may adopt by reference the guidelines for perinatal care established by the American academy of pediatrics and the American college of obstetricians and gynecologists which provide that when complications are not present, the postpartum hospital stay ranges from a minimum of forty-eight hours for a vaginal delivery to a minimum of ninety-six hours for a cesarean birth, excluding the day of delivery. The guidelines adopted by rule by the commissioner shall also provide that in the event of a discharge from the hospital prior to the minimum stay established in the guidelines, a postdischarge follow-up visit shall be provided to the mother and newborn by providers competent in postpartum care and newborn assessment if determined medically appropriate as directed by the attending physician, in accordance with the guidelines.
2. When performing utilization review of inpatient hospital services related to maternity and newborn care, including but not limited to length of postdelivery stay and postdischarge follow-up care, any person who provides an individual or group policy of accident or health insurance or individual or group hospital or health care service contract issued pursuant to chapter 509, 509A, 514, or 514A, or an individual or group health maintenance organization contract issued and regulated under chapter 514B, shall use the guidelines adopted by rule by the commissioner, and shall not deselect, require additional documentation, require additional utilization review, terminate services to, reduce payment to, or in any manner provide a disincentive to an attending physician solely on the basis that the attending physician provided or directed the provision of services in compliance with the guidelines adopted by rule.
3. Preauthorization or precertification for a hospital stay or for a postdischarge follow-up visit in accordance with the guidelines adopted by rule by the commissioner shall not be required.
96 Acts, ch 1202, §1
Structure Iowa Code
Chapter 514C - SPECIAL HEALTH AND ACCIDENT INSURANCE COVERAGES
Section 514C.1 - Supplemental coverage for adopted or newly born children.
Section 514C.2 - Skilled nursing care covered in hospitals.
Section 514C.3 - Dentist’s services under accident and sickness insurance policies.
Section 514C.3A - Disclosures relating to dental coverage reimbursement rates.
Section 514C.3B - Dental coverage — fee schedules.
Section 514C.4 - Mandated coverage for mammography.
Section 514C.5 - Prescription drug benefit restrictions.
Section 514C.6 - Uniformity of treatment — employee welfare benefit plans.
Section 514C.8 - Coordination of health care benefits with state medical assistance.
Section 514C.9 - Medical support — insurance requirements.
Section 514C.10 - Coverage for adopted child.
Section 514C.12 - Postdelivery benefits and care.
Section 514C.14 - Continuity of care — pregnancy.
Section 514C.15 - Treatment options.
Section 514C.16 - Emergency room services.
Section 514C.17 - Continuity of care — terminal illness.
Section 514C.18 - Diabetes coverage.
Section 514C.19 - Prescription contraceptive coverage.
Section 514C.20 - Mandated coverage for dental care — anesthesia and certain hospital charges.
Section 514C.21 - Coverage for immunizations — mercury.
Section 514C.22 - Biologically based mental illness coverage.
Section 514C.23 - Human papilloma virus vaccinations — coverage.
Section 514C.24 - Cancer treatment — coverage.
Section 514C.25 - Coverage for prosthetic devices.
Section 514C.26 - Approved cancer clinical trials coverage.
Section 514C.27 - Mental illness and substance abuse treatment coverage for veterans.
Section 514C.28 - Autism spectrum disorders coverage.
Section 514C.29 - Services provided by a doctor of chiropractic.
Section 514C.31 - Applied behavior analysis for treatment of autism spectrum disorder — coverage.
Section 514C.33 - Services provided by provisionally licensed psychologists.
Section 514C.34 - Health care services delivered by telehealth — coverage.
Section 514C.35 - Behavioral health services provided in a school — coverage.