Section 8H. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued or renewed in the commonwealth shall provide, as a basic benefit to all individual subscribers and members within the commonwealth and to all group members having a principal place of employment within the commonwealth, for expense for prenatal care, childbirth and post partum care to the same extent that benefits are provided for medical conditions not related to pregnancy.
In addition to such benefits, such policy or plan shall provide coverage of a minimum of forty-eight hours of in-patient care following a vaginal delivery and a minimum of ninety-six hours of in-patient care following a caesarean section for a mother and her newly born child. Any decision to shorten these minimum coverages shall be made by the attending physician in consultation with the mother. Any such decision shall be made in accordance with rules and regulations promulgated by the department of public health. Said regulations shall be relative to early discharge, defined as less than forty-eight hours for a vaginal delivery and ninety-six hours for a caesarean delivery and post-delivery care and shall include, but not be limited to, home visits, parent education, assistance and training in breast or bottle feeding and the performance of any necessary and appropriate clinical tests; provided, however, that the first home visit shall be conducted by a registered nurse, physician, or certified nurse midwife; and provided, further, that any subsequent home visit determined to be clinically necessary shall be provided by a licensed health care provider.
For the purposes of this section, attending physician shall include the attending obstetrician, pediatrician, or certified nurse midwife attending the mother and newly born child.
Any subscriber or member who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of public health.
Structure Massachusetts General Laws
Part I - Administration of the Government
Chapter 176a - Non-Profit Hospital Service Corporations
Section 1a - Right to Become Subscriber; Open Enrollment Periods
Section 1b - Medicare Supplemental Group Coverage; Medical Assistance Recipients
Section 1c - Retroactive Premium Rate Increase
Section 1d - Contracts of Reinsurance
Section 2 - Incorporators; Directors; Certificate of Organization; Commissioner's Examination Report
Section 3 - Certificate of Compliance; Examination by Commissioner
Section 3a - Discrimination Against Abuse Victims in Terms of Hospital Service Plans
Section 3b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information
Section 4 - Accounting System; Accountant, Claim Manager, Underwriter and Actuary
Section 5 - Joint Administration With Certain Corporations
Section 6 - Approval of Nongroup Contracts
Section 7 - Information Gathering Authority of Commissioner; Confidentiality and Privilege
Section 8 - Conditions to Issuance or Delivery of Contract
Section 81/2 - Sale of Group Non-Profit Hospital Service Contracts
Section 8a3/4 - Retroactive Claims Denials for Behavioral Health Services
Section 8b - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion in Contracts
Section 8c - Refusal to Contract With Blind or Deaf Persons; Prohibition
Section 8d - Limited Extension of Benefits
Section 8e - Diethylstilbestrol Exposure; Discrimination
Section 8f - Divorced or Separated Spouses; Continuation of Eligibility for Benefits
Section 8g - Cardiac Rehabilitation Expense Benefits
Section 8h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care
Section 8i - Home Care Benefits
Section 8k - Infertility Diagnosis and Treatment Benefits
Section 8l - Nonprescription Enteral Formulas for Home Use
Section 8m - Standardized Claim Form
Section 8n - Off-Label Drug Use; Cancer
Section 8o - Hospital Service Plan Benefits for Bone Marrow Transplants
Section 8p - Items Medically Necessary for Diagnosis and Treatment of Diabetes
Section 8q - HIV/AIDS Treatment; Off-Label Prescription Drug Coverage
Section 8r - Coverage of Hospice Services for Terminally Ill Patients
Section 8s - Nurse Anesthetist and Nurse Practitioner Services
Section 8t - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment
Section 8u - Emergency Services Provided to Insureds for Emergency Medical Conditions
Section 8v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
Section 8x - Coverage for Patient Care Services Under Qualified Clinical Trials
Section 8y - Diagnosis and Treatment of Speech, Hearing and Language Disorders
Section 8aa - Coverage of Prosthetic Devices and Repairs
Section 8bb - Coverage for Eligible Dependents Under 26 Years of Age
Section 8cc - Coverage for Medically Necessary Hypodermic Syringes or Needles
Section 8dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder
Section 8ee - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate
Section 8ff - Coverage for Orally Administered Anticancer Medications
Section 8gg - Coverage for Abuse Deterrent Opioid Drug Products
Section 8hh - Preauthorization for Substance Abuse Treatment Not to Be Required
Section 8ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services
Section 8jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease
Section 8mm - Pain Management Access Plans
Section 8nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products
Section 8pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs
Section 8qq - Coverage for Prescription Eye Drops
Section 10 - Group Hospital Service Plan; Approval or Disapproval of Contracts and Rates; Filing
Section 10a - Preferred Provider Arrangements
Section 12 - Publication of Assets and Liabilities
Section 13 - Hospitalization and Medical Service for Officers and Employees of Corporation
Section 14 - Misrepresentation of Terms of Subscriber's Contract
Section 14b - Disclosure of Information; Mental or Nervous Conditions; Exceptions
Section 15 - Costs of Solicitation of Subscribers and Administration
Section 17 - Submission of Disputes and Controversies
Section 18a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset
Section 20 - Filing of Amendment of By-Laws
Section 21 - Submission of Advertising Matter to Commissioner
Section 22 - Filing of Riders, Endorsements and Applications With Commissioner
Section 24 - Special Contingent Reserve Fund
Section 25 - Licensing of Agents
Section 26 - Salaries, Compensation or Emoluments Paid by Corporation
Section 27 - Payroll Deductions for Governmental Employees
Section 28 - Violations; Penalties
Section 31 - Contracts for Administrative or Other Services; Loans and Investments
Section 32 - Payment of Sums Owed to Subscriber's Estate
Section 33 - Insolvency of Health Maintenance Organization; Replacement Coverage
Section 34 - Report of Individuals Provided With Creditable Coverage
Section 36 - Attribution of Members to a Primary Care Provider