A.5966/S.1241 Medicaid Maternity

This legislation, A.5966/S.1241, would require Medicaid to provide coverage for maternity patients and their newborns for inpatient hospital stays of at least 48 hours for natural delivery and 96 hours following caesarean section.  However, statutory and regulatory provisions already require these protections, and also provides patients the option to choose to be discharged before the mandated time period, with the provision of a home care visit for such patients.

For example, Chapter 56 of 1996 established mandatory minimum periods of coverage by insurers for maternity stays.  While the sponsor of this bill indicates that this legislation is necessary to assure that Medicaid members “are not treated differently than those covered by private insurance,” the statutory provisions of Chapter 56 of 1996 already apply to the Medicaid program, making this legislation unnecessary.

Further, existing mandatory Department of Health guidance already requires all insurers to provide the following coverage:

After Delivery…In-Patient Hospital Coverage

Each health care insurer in New York State is required to provide inpatient hospital coverage for a mother and her newborn for at least 48 hours after childbirth for vaginal delivery and at least 96 hours after a cesarean section. In addition, each hospital must provide parent education, assistance and training in breast or bottle feeding, and any necessary maternal or newborn clinical assessments.

 If you choose to leave the hospital earlier, your inpatient coverage will be extended to include at least one home care visit. The home care visit will provide parent education, assistance and training in breast or bottle feeding, and any necessary maternal or newborn clinical assessments. This visit will be in addition to any home care coverage available under your insurance policy.

DOH site:  https://profiles.health.ny.gov/hospital/pages/maternity

As stakeholders continue to work on maternal health and maternal mortality issues, including best practices for pre-natal and post-partum care, and addressing behavioral health and social care needs as part of comprehensive maternity care, a narrow focus on inpatient stays for childbirth no longer reflects the more inclusive nature of the discussion around maternity care.

As statutory and regulatory protections already exist, HPA opposes A.5966/S.1241.