New law aims to prevent ‘drive-by deliveries’

After Jan. 1, 1998, a mother will be able to stay in the hospital with her newborn a little longer if she wants to and have no worries that her health plan won’t pick up the tab. But before you breathe a sigh of relief, there are some things you need to know about this new legislation, signed by President Clinton in September 1996.

It’s not a very powerful law, says Julietta Appleton, MPA, CCE, project coordinator for the Early Postpartum Discharge Program at the Maternity Center Association in New York City. First of all, the federal legislation will ot supersede a better state law mandating a 48-hour stay after a normal vaginal delivery and 96 hours after a cesarean. For example, your state law may stipulate that home care must be provided to women who choose not to stay, but the final federal law does not, although earlier drafts asked for it. In this case you will continue to be reimbursed for home care, she says.

Insurers argued against the federal bill’s language stipulating mandatory home care, and it was eventually dropped, says Carol Vargo, a lobbyist for the American College of Obstetricians and Gynecologists (ACOG), based in Washington, DC. It’s not that they are against the idea; they just balked at an additional mandate, she says, explaining, "It was a tough pill to swallow after they were forced into [paying for the extra day]."

There are also a few exclusions to the federal law. Medicaid patients and those covered by health plans of small employers won’t be able to choose an extra day and have it paid for, Appleton points out.

Vargo predicts that eventually, reimbursement for home care will be mandated, too. "A lot of people on the Hill are very interested in this topic," she says. "I don’t think this debate is going to go away."

[Editor’s note: Do you know what your state law mandates about maternal lengths of stay and the provision of home care, or if there is one? Many women’s center managers we spoke to didn’t. To get yourself up to speed, see the ACOG chart that provides a brief outline of laws and regulations of the 29 states that have them, enclosed in this issue. For more information, contact: Department of Government Relations, ACOG, P.O. Box 96920, Washington, DC 20090. Telephone: (202) 863-2509.]