The Newborns’ and Mothers’ Health Protection Act sets minimum hospital stays.
This federal law sets minimum hospital stays for mothers and newborns in group health plans that cover maternity benefits.
The Basics for Employers.
A plain-English summary. This is general information, not legal advice, and the rules change, so check the current text.
Length of Stay
Plans cannot limit coverage to less than 48 hours after a vaginal delivery or 96 hours after a cesarean section.
No Preauthorization
Plans cannot require preauthorization for a stay within those lengths.
Early Discharge
The mother and provider can decide on an earlier discharge, and plans cannot pressure either to do so.
How it plays out.
The Newborns’ and Mothers’ Health Protection Act sets a floor for hospital stays after childbirth. A plan that covers childbirth generally cannot limit the stay to less than 48 hours after a vaginal delivery or 96 hours after a cesarean section, unless the attending provider and the mother agree to an earlier discharge.
It also bars plans from requiring prior authorization for those stays, and from penalizing the provider or mother for staying the minimum period.
The statute is short and most plans already meet it, but the rule shows up in plan summaries. A summary plan description for a plan that covers childbirth should include a statement about it.
Where This Shows Up in Your Plan.
ERISA, ACA Reporting and Form 5500 Support
How we help with the filings, notices and plan documents.
Employer Benefits Guides: Eligibility, Plan Design, Life Events and Rules
Eligibility, plan design and life-event rules in one place.
Checking the plan.
Read the Plan Terms
Look for stay limits for childbirth.
Check Prior Authorization
Confirm none is required for the minimum stay.
Review the SPD
Confirm the required statement is included.
Ask the Carrier
Get written confirmation of compliance.
Mistakes to avoid.
Shorter Stay Limits
These are generally not allowed.
Missing Statement
The summary should include the notice.
Penalizing Providers
Plans cannot reduce payment to push an earlier discharge.
Other Rules Employers Work With.
Women’s Health and Cancer Rights Act
29 U.S.C. 1185b
Affordable Care Act
Public Law 111-148
ACA Reporting
26 U.S.C. 6056
Laws and Rules Referenced
Newborns’ and Mothers’ Health Protection Act (29 U.S.C. 1185) — The statute or rule text from its official or public source.
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