PARRIS N. GLENDENING, Governor                             Ch. 397

THE NEWBORN REMAIN IN THE HOSPITAL, A HEALTH MAINTENANCE
ORGANIZATION SHALL PROVIDE AS PART OF ITS HOSPITALIZATION SERVICES
PROVIDED TO MEMBERS AND SUBSCRIBERS PAYMENT FOR THE COST OF
ADDITIONAL HOSPITALIZATION FOR THE NEWBORN FOR UP TO 4 DAYS.

(2) THE ATTENDING PHYSICIAN OR CERTIFIED NURSE MIDWIFE OF THE
MOTHER, OR THE DESIGNEE OF THE ATTENDING PHYSICIAN OR CERTIFIED NURSE
MIDWIFE SHALL PROVIDE NOTICE TO THE MOTHER OF THE PROVISIONS OF
PARAGRAPH (1) OF THIS SUBSECTION.

19-706.

(i) The provisions of Article 48A, §§ 490U, 490AA, 490CC, [and] 490DD, AND
490FF of the Code shall apply to health maintenance organizations.

19-1305.4.

(A) IN THIS SECTION, "ATTENDING PHYSICIAN PROVIDER" MEANS AN
OBSTETRICIAN, PEDIATRICIAN, OR OTHER PHYSICIAN OR CERTIFIED NURSE
MIDWIFE OR PEDIATRIC NURSE PRACTITIONER ATTENDING THE MOTHER OR
NEWBORN CHILD.

[(a)](B) Except as provided in [subsection (b)] SUBSECTIONS (C) AND (D) of
this section, the criteria and standards used by a private review agent or health
maintenance organization in performing utilization review of hospital services related to
maternity and newborn care, including length of stay, shall be in accordance with the
medical criteria outlined in the most current version of the "Guidelines for Perinatal
Care" prepared by the American Academy of Pediatrics and the American College of
Obstetricians and Gynecologists.

(C) SUBJECT TO THE PROVISIONS OF SUBSECTION (D) OF THIS SECTION, A
PRIVATE REVIEW AGENT OR HEALTH MAINTENANCE ORGANIZATION PERFORMING
UTILIZATION REVIEW OF HOSPITAL SERVICES RELATED TO MATERNITY AND
NEWBORN CARE SHALL AUTHORIZE A MINIMUM COVERAGE OF:

(1)     48 HOURS OF INPATIENT HOSPITALIZATION CARE FOLLOWING A
AN UNCOMPLICATED VAGINAL DELIVERY; AND

(2)     96 HOURS OF INPATIENT HOSPITALIZATION CARE FOLLOWING A
AN UNCOMPLICATED CESAREAN SECTION.

[(b)](D) A private review agent or health maintenance organization may
authorize a shorter length of hospital stay for services related to maternity and newborn
care REQUIRED UNDER SUBSECTION (C) OF THIS SECTION [provided the newborn
meets the criteria for medical stability in the "Guidelines for Perinatal Care" and] IF the
private review agent or health maintenance organization authorizes for the mother and
child an initial postpartum home visit which would include the collection of an adequate
sample for the hereditary and metabolic newborn screening, when indicated, UNLESS
THE ATTENDING PHYSICIAN, CONSISTENT WITH THE CRITERIA OUTLINED IN THE
MOST CURRENT VERSION OF THE "GUIDELINES FOR PERINATAL CARE",
DETERMINES THAT THE INPATIENT HOSPITALIZATION LENGTH OF STAY REQUIRED
UNDER SUBSECTION (C) OF THIS SECTION IS NECESSARY.

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