Bichotte Hermelyn, Hyndman, Glick, Woerner, De Los Santos, Seawright, Simone, Simon, Bores
MLTSPNSR
Colton, Dinowitz
Amd §365-a, Soc Serv L
Requires all insurance policies and health maintenance organization contracts to provide coverage for maternity patients and their newborns for hospital stays of at least 48 hours following childbirth by natural delivery and 96 hours following childbirth by caesarean section; provides such coverage for patients who are recipients of medicaid.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7681
SPONSOR: Cook (MS) TITLE OF BILL:
An act to amend the social services law, in relation to establishing
mandatory minimum medicaid coverage for hospital confinement for child-
birth
PURPOSE:
To require Medicaid to provide coverage for maternity patients and their
newborns for hospital stays of at least 48 hours for natural delivery
and 96 hours following caesarean section as is currently provided by
private insurers and HMO's.
SUMMARY OF PROVISIONS:
Section 1 adds a new subdivision 6-a to Social services Law § 365-a to
require Medicaid to provide coverage for maternity patients and their
newborns for hospital stays of at least 48 hours for natural delivery
and 96 hours following caesarean section. It also provides that coverage
may be provided for a shorter period of time in such case the in
patience hospital coverage must include at least one home care visit in
addition to any home health care coverage otherwise available.
Section 2 provides that the act shall take effect 180 days after becom-
ing law.
EXISTING LAW:
Chapter 56 of 1996 established mandatory minimum periods of coverage by
insurers and HMO's and care by hospitals for maternity stays following
childbirth.
JUSTIFICATION:
In 1996 the legislature addressed the growing trend of "Revolving Door
Deliveries," in which HMOs, insurance companies and hospitals were
restricting the length of maternity stay for mothers and newborns
following childbirth to 24 hours or less, based upon financial rather
than public health considerations. Such early discharges can be detri-
mental to the health of both mother and newborn, particularly because
many conditions which affect newborns, such as jaundice, do not manifest
themselves during the first 24 hours of life.
The legislation adopted in 1996 established mandatory minimum periods of
coverage for maternity stays following childbirth, however it did not
include the same protections for those whose care is paid for through
Medicaid. This bill insurers that those covered by Medicaid are not
treated differently than those covered by private insurance. It estab-
lishes the same 'mandatory minimum periods of coverage under Medicaid
that private insurers are bound to provide.
LEGISLATIVE HISTORY:
Previously introduced. 2019/20 A.6381/S.9111; 2021/22 A.3386/S.916;
2023/24 A.5996/S. 1241
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law.
STATE OF NEW YORK
________________________________________________________________________
7681
2025-2026 Regular Sessions
IN ASSEMBLY
April 4, 2025
___________
Introduced by M. of A. COOK, BICHOTTE HERMELYN, HYNDMAN, GLICK, WOERNER,
DE LOS SANTOS, SEAWRIGHT, SIMONE, SIMON, BORES -- Multi-Sponsored by
-- M. of A. COLTON, DINOWITZ -- read once and referred to the Commit-
tee on Health
AN ACT to amend the social services law, in relation to establishing
mandatory minimum medicaid coverage for hospital confinement for
childbirth
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 365-a of the social services law is amended by
2 adding a new subdivision 6-a to read as follows:
3 6-a. (a) Medical assistance shall also include inpatient hospital
4 coverage for mother and for newborn for at least forty-eight hours after
5 childbirth for any delivery other than a caesarean section, and for at
6 least ninety-six hours after a caesarean section.
7 (b) Maternity care coverage shall also include, at a minimum, parent
8 education, assistance and training in breast or bottle feeding, and the
9 performance of any necessary maternal and newborn clinical assessments.
10 (c) A mother shall have the option to be discharged earlier than the
11 time periods established in paragraph (a) of this subdivision. In such
12 case, the inpatient hospital coverage must include at least one home
13 care visit, which shall be in addition to, rather than in lieu of, any
14 home health care coverage otherwise available. The medical assistance
15 program must cover the home care visit which may be requested at any
16 time within forty-eight hours of the time of delivery (ninety-six hours
17 in the case of a caesarean section) and shall be delivered within twen-
18 ty-four hours, (i) after discharge, or (ii) of the time of the mother's
19 request, whichever is later.
20 § 2. This act shall take effect on the one hundred eightieth day after
21 it shall have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03095-01-5
