PARRIS N. GLENDENING, Governor

Ch. 396

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.

[(b) A private review agent or health maintenance organization may authorize a
shorter length of hospital stay for services related to maternity and newborn care
provided the newborn meets the criteria for medical stability in the "Guidelines for
Perinatal Care" and 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.]

(C) EXCEPT AS PROVIDED UNDER 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 OF:

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

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

(D) (1) THE PRIVATE REVIEW AGENT OR HEALTH MAINTENANCE
ORGANIZATION MAY AUTHORIZE A SHORTER LENGTH OF STAY THAN THAT
PROVIDED IN SUBSECTION (C) OF THIS SECTION IF THE MOTHER, IN CONSULTATION
WITH HER ATTENDING PROVIDER DECIDES THAT LESS TIME IS NEEDED FOR
RECOVERY.

(2) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION, THE
PRIVATE REVIEW AGENT OR HEALTH MAINTENANCE ORGANIZATION PERFORMING
UTILIZATION REVIEW SHALL AUTHORIZE. FOR A MOTHER AND NEWBORN CHILD, A
MINIMUM OF ONE HOME VISIT;

(I) IN ACCORDANCE WITH GENERALLY ACCEPTED STANDARDS
OF NURSING PRACTICE FOR HOME CARE OF A MOTHER AND NEWBORN CHILD; AND

(II) BY A REGISTERED NURSE WITH AT LEAST 1 YEAR OF
EXPERIENCE IN MATERNAL AND CHILD HEALTH NURSING OR IN COMMUNITY
HEALTH NURSING WITH AN EMPHASIS ON MATERNAL AND CHILD HEALTH.

(2) (3) FOR A MOTHER AND NEWBORN CHILD WHO HAVE A HOSPITAL
STAY SHORTER IN LENGTH THAN THAT PROVIDED UNDER SUBSECTION (C) OF THIS
SECTION, THE PRIVATE REVIEW AGENT OR HEALTH MAINTENANCE ORGANIZATION
PERFORMING UTILIZATION REVIEW SHALL AUTHORIZE A MINIMUM OF 3 2 HOME
VISITS:

(I) IN ACCORDANCE WITH GENERALLY ACCEPTED STANDARDS
OF NURSING PRACTICE FOR HOME CARE OF A MOTHER AND NEWBORN CHILD; AND

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