(a) Nothing in this section shall be construed to require a mother to give birth in a hospital or to stay in the hospital for a fixed period of time following the birth of her child, but if a health benefit plan, for plan years beginning on or after January 1, 1998, provides inpatient benefits in connection with childbirth for a mother or her newborn child:
(1) The plan may not restrict benefits for any hospital stay following a normal vaginal delivery to less than forty-eight hours or following a cesarean section to less than ninety-six hours, or require a provider to obtain authorization for such length hospital stays;
(2) The plan must cover maternity and pediatric care in accordance with guidelines established by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics or other established professional medical association; and
(3) The mother and her newborn child may be discharged prior to the expiration of the minimum length of stay required under this section only in those cases in which the decision to discharge is made by an attending provider in consultation with the mother.
(b) Benefits provided for under this section may be made subject to deductibles, coinsurance or other cost-sharing if such cost-sharing is no greater than cost-sharing for any preceding portion of the mother's or newborn child's hospital stay.
(c) Nothing in this section shall be construed to prevent a health insurer from negotiating with a provider the level and type of reimbursement for inpatient maternity or newborn care provided under a health benefit plan.
Structure West Virginia Code
Article 16. Group Accident and Sickness Insurance
§33-16-3. Required Policy Provisions
§33-16-3b. Home Health Care Coverage
§33-16-3bb. Coverage for Amino Acid-Based Formulas
§33-16-3cc. Substance Use Disorder
§33-16-3d. Medicare Supplement Insurance
§33-16-3dd. Prior Authorization
§33-16-3e. Policies to Cover Nursing Services
§33-16-3ee. Fairness in Cost-Sharing Calculation
§33-16-3ff. Mental Health Parity
§33-16-3g. Third Party Reimbursement for Mammography, Pap Smear or Human Papilloma Virus Testing
§33-16-3gg. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-16-3h. Third Party Reimbursement for Rehabilitation Services
§33-16-3hh. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-16-3i. Coverage of Emergency Services
§33-16-3j. Hospital Benefits for Mothers and Newborns
§33-16-3k. Limitations on Preexisting Condition Exclusions for Health Benefit Plans
§33-16-3l. Renewability and Modification of Health Benefit Plans
§33-16-3m. Creditable Coverage
§33-16-3n. Eligibility for Enrollment
§33-16-3o. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-16-3p. Required Coverage for Reconstruction Surgery Following Mastectomies
§33-16-3q. Required Use of Mail-Order Pharmacy Prohibited
§33-16-3r. Coverage for Patient Cost of Clinical Trials
§33-16-3s. Third-Party Reimbursement for Kidney Disease Screening
§33-16-3t. Required Coverage for Dental Anesthesia Services
§33-16-3u. Special Enrollment Period Under the American Recovery and Reinvestment Act of 2009
§33-16-3v. Required Coverage for Treatment of Autism Spectrum Disorders
§33-16-3x. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-16-3y. Eye Drop Prescription Refills
§33-16-3z. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-16-3zz. Lyme Disease to Be Covered by All Health Insurance Policies
§33-16-5. Contingencies for Which Benefits or Reimbursement of Expenses Permitted
§33-16-6. Rider Changing Individual Policy to Group Policy Prohibited
§33-16-7. Hospital Indemnity Policies Not to Exclude Coverage for Confinement in Government Hospital
§33-16-8. Continuum of Care Services
§33-16-10. Policies Discriminating Among Health Care Providers
§33-16-12. Child Immunization Services Coverage
§33-16-13. Equal Treatment of State Agency
§33-16-14. Coordination of Benefits With Medicaid
§33-16-16. Insurance for Diabetics
§33-16-17. Commissioner to Propose Rules
§33-16-18. Assignment of Certain Benefits in Dental Care Insurance Coverage