BY REPRESENTATIVES Morrison, Chavez, Dyer, Epps, Gordon, Grossman, Hagedorn, Mace, Nichol, Saliman, Tupa, Udall, Veiga, S. Williams, and Zimmerman;
also SENATORS Reeves, Hernandez, Hopper, Martinez,
Pascoe, Phillips, Rupert, Tanner, Thiebaut, Weddig, and Wham.
CONCERNING THE TERMS OF MANDATORY HEALTH CARE COVERAGE
PROVISIONS FOR NEWBORN CHILDREN AND MATERNITY, AND, IN CONNECTION
THEREWITH, REQUIRING THAT SUCH COVERAGES INCLUDE A MINIMUM LENGTH
OF A HOSPITAL STAY AFTER CHILDBIRTH.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 1016104
(1) (b), Colorado Revised Statutes, is RECREATED AND REENACTED,
WITH AMENDMENTS, to read:
1016104. Mandatory coverage
provisions. (1) Newborn
children. (b) (I) COVERAGE FOR A HOSPITAL
STAY FOR A NEWBORN FOLLOWING A NORMAL VAGINAL DELIVERY SHALL NOT
BE LIMITED TO LESS THAN FORTYEIGHT HOURS. IF FORTYEIGHT
HOURS FOLLOWING DELIVERY FALLS AFTER 8 P.M., COVERAGE SHALL CONTINUE
UNTIL 8 A.M. THE FOLLOWING MORNING.
(II) COVERAGE FOR A HOSPITAL STAY FOR
A NEWBORN FOLLOWING A CESAREAN SECTION SHALL NOT BE LIMITED TO
LESS THAN NINETYSIX HOURS. IF NINETYSIX HOURS FOLLOWING
THE CESAREAN SECTION FALLS AFTER 8 P.M., COVERAGE SHALL CONTINUE
UNTIL 8 A.M. THE FOLLOWING MORNING.
(III) THE PROVISIONS OF SUBPARAGRAPHS
(I) AND (II) OF THIS PARAGRAPH (b) SHALL NOT APPLY IN ANY CASE
IN WHICH THE DECISION TO DISCHARGE THE NEWBORN PRIOR TO THE MINIMUM
LENGTH OF STAY OTHERWISE REQUIRED UNDER SUBPARAGRAPHS (I) AND
(II) OF THIS PARAGRAPH (b) IS MADE BY AN ATTENDING PROVIDER WITH
THE AGREEMENT OF THE MOTHER.
(IV) NOTHING IN THIS PARAGRAPH (b) SHALL
BE CONSTRUED TO REQUIRE A MOTHER WHO IS A PARTICIPANT OR BENEFICIARY
TO GIVE BIRTH IN A HOSPITAL OR TO STAY IN THE HOSPITAL FOR A FIXED
PERIOD OF TIME AFTER THE BIRTH OF HER CHILD.
(V) NOTHING IN THIS PARAGRAPH (b) SHALL
BE CONSTRUED AS PREVENTING A CARRIER FROM IMPOSING DEDUCTIBLES,
COINSURANCE, OR OTHER COSTSHARING IN RELATION TO BENEFITS
FOR HOSPITAL LENGTHS OF STAY IN CONNECTION WITH CHILDBIRTH FOR
A MOTHER OR NEWBORN CHILD UNDER THE PLAN; EXCEPT THAT SUCH COINSURANCE
OR OTHER COSTSHARING FOR ANY PORTION OF A PERIOD WITHIN
A HOSPITAL LENGTH OF STAY REQUIRED UNDER SUBPARAGRAPHS (I) AND
(II) OF THIS PARAGRAPH (b) MAY NOT BE GREATER THAN SUCH COINSURANCE
OR COSTSHARING FOR ANY OTHER SICKNESS, INJURY, DISEASE,
OR CONDITION THAT IS OTHERWISE COVERED UNDER THE POLICY OR CONTRACT.
SECTION 2. 1016104
(3) (a), Colorado Revised Statutes, is amended to read:
1016104. Mandatory coverage
provisions. (3) Maternity
coverage. (a) (I) All group sickness and accident
insurance policies providing coverage within the state and issued
to an employer by an entity subject to the provisions of part
2 of this article and all group health service contracts issued
by an entity subject to the provisions of part 3 or 4 of this
article and issued to an employer shall insure against the expense
of normal pregnancy and childbirth or provide coverage for maternity
care therefor in the same manner as any other sickness, injury,
disease, or condition is otherwise covered under the policy or
contract. However, in the event that
an employer changes health insurance carriers,
Policies or contracts the new carrier,
policy, or contract shall not exclude
coverage for normal
pregnancy and delivery expenses on the grounds that pregnancy
was a preexisting condition. if:
(I) The pregnant person was covered
under the employer's former policy or contract; and
(II) Coverage under the new carrier,
policy, or contract came into effect within ninety days of termination
or lapse of the former policy or contract.
(II) COVERAGE FOR A HOSPITAL STAY FOLLOWING
A NORMAL VAGINAL DELIVERY SHALL NOT BE LIMITED TO LESS THAN FORTYEIGHT
HOURS. IF FORTYEIGHT HOURS FOLLOWING DELIVERY FALLS AFTER
8 P.M., COVERAGE SHALL CONTINUE UNTIL 8 A.M. THE FOLLOWING
MORNING.
(III) COVERAGE FOR A HOSPITAL STAY FOLLOWING
A CESAREAN SECTION SHALL NOT BE LIMITED TO LESS THAN NINETYSIX
HOURS. IF NINETYSIX HOURS FOLLOWING THE CESAREAN SECTION
FALLS AFTER 8 P.M., COVERAGE SHALL CONTINUE UNTIL 8 A.M.
THE FOLLOWING MORNING.
(IV) THE PROVISIONS OF SUBPARAGRAPHS (II)
AND (III) OF THIS PARAGRAPH (a) SHALL NOT APPLY IN ANY CASE IN
WHICH THE DECISION TO DISCHARGE PRIOR TO THE MINIMUM LENGTH OF
STAY OTHERWISE REQUIRED UNDER SUBPARAGRAPHS (II) AND (III) OF
THIS PARAGRAPH (a) IS MADE BY AN ATTENDING PROVIDER WITH THE AGREEMENT
OF THE MOTHER.
(V) NOTHING IN THIS PARAGRAPH (a) SHALL
BE CONSTRUED TO REQUIRE A MOTHER WHO IS A PARTICIPANT OR BENEFICIARY
TO GIVE BIRTH IN A HOSPITAL OR TO STAY IN THE HOSPITAL FOR A FIXED
PERIOD OF TIME AFTER THE BIRTH OF HER CHILD.
(VI) NOTHING IN THIS PARAGRAPH (a) SHALL
BE CONSTRUED AS PREVENTING A CARRIER FROM IMPOSING DEDUCTIBLES,
COINSURANCE, OR OTHER COSTSHARING IN RELATION TO BENEFITS
FOR HOSPITAL LENGTHS OF STAY IN CONNECTION WITH CHILDBIRTH FOR
A MOTHER OR NEWBORN CHILD UNDER THE PLAN; EXCEPT THAT SUCH COINSURANCE
OR OTHER COSTSHARING FOR ANY PORTION OF A PERIOD WITHIN
A HOSPITAL LENGTH OF STAY REQUIRED UNDER SUBPARAGRAPHS (II) AND
(III) OF THIS PARAGRAPH (a) MAY NOT BE GREATER THAN SUCH COINSURANCE
OR COSTSHARING FOR ANY OTHER SICKNESS, INJURY, DISEASE,
OR CONDITION THAT IS OTHERWISE COVERED UNDER THE POLICY OR CONTRACT.
SECTION 3. Safety
clause. The general assembly hereby finds, determines, and
declares that this act is necessary for the immediate preservation
of the public peace, health, and safety.
____________________________ ____________________________
Charles E. Berry Tom Norton
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Judith M. Rodrigue Patricia K. Dicks
CHIEF CLERK OF THE HOUSE ASSISTANT SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO