Minnesota Legislature
HF 3893
as introduced - 93rd Legislature (2023 - 2024) Posted on 02/15/2024 09:35am
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A bill for an act
relating to insurance; requiring health plans to cover prenatal, maternity, and
postnatal care; amending Minnesota Statutes 2022, sections 62A.041, subdivision
1; 62A.0411; 62A.047; 62Q.521; repealing Minnesota Statutes 2022, section
62A.041, subdivision 2.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2022, section 62A.041, subdivision 1, is amended to read:
Subdivision 1.
Discrimination prohibited against unmarried women.
Each group
policy of accident and health insurance and each group health maintenance contract health
plan, as defined in section 62Q.01, subdivision 3, shall provide the same coverage for
maternity benefits to unmarried women and minor female dependents that it provides to
married women including the wives of employees choosing dependent family coverage. If
an unmarried insured or an unmarried enrollee is a parent of a dependent child, each group
policy and each group contract health plan shall provide the same coverage for that child
as that provided for the child of a married employee choosing dependent family coverage
if the insured or the enrollee elects dependent family coverage.
Each individual policy of accident and health insurance and each individual health
maintenance contract shall provide the same coverage for maternity benefits to unmarried
women and minor female dependents as that provided for married women. If an unmarried
insured or an unmarried enrollee is a parent of a dependent child, each individual policy
and each individual contract shall also provide the same coverage for that child as that
provided for the child of a married insured or a married enrollee choosing dependent family
coverage if the insured or the enrollee elects dependent family coverage.
EFFECTIVE DATE.
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
Sec. 2.
Minnesota Statutes 2022, section 62A.0411, is amended to read:
62A.0411 MATERNITY CARE.
Subdivision 1.
Minimum inpatient care.
(a) Every health plan as defined in section
62Q.01, subdivision 3, that provides maternity benefits must, consistent with other
coinsurance, co-payment, deductible, and related contract terms, provide coverage of a
minimum of 48 hours of inpatient care following a vaginal delivery and a minimum of 96
hours of inpatient care following a caesarean section for a mother and her newborn. The
health plan shall not provide any compensation or other nonmedical remuneration to
encourage a mother and newborn to leave inpatient care before the duration minimums
specified in this section.
(b) In addition to the coverage required under paragraph (a), every health plan must
provide coverage for all inpatient care provided to a mother and her newborn that is: (1)
recommended by a health care provider acting within the provider's scope of practice; and
(2) related to the delivery and associated well-being of the mother and newborn. The coverage
required under this paragraph includes but is not limited to all procedures, examinations,
screenings, counseling, education, and inpatient care extending beyond the minimum
durations provided in paragraph (a).
(c) If a health care provider acting within the provider's scope of practice recommends
that either the mother or newborn be transferred to a different medical facility, every health
plan must provide the coverage required under this section for the mother, newborn, and
newborn siblings at both medical facilities. The coverage required under this paragraph
includes but is not limited to expenses related to transferring all individuals from one medical
facility to a different medical facility.
Subd. 2.
Minimum postdelivery outpatient care.
(a) The health plan must also provide
coverage for postdelivery outpatient care to a mother and her newborn if the duration of
inpatient care is less than the minimums provided in this section.
(b) Postdelivery outpatient care consists of a minimum of one home visit by a registered
nurse and all postdelivery outpatient care provided to a mother and her newborn that is: (1)
recommended by a health care provider acting within the provider's scope of practice; and
(2) related to the delivery and associated well-being of the mother and newborn. The coverage
required under this paragraph includes but is not limited to all procedures, examinations,
screenings, counseling, education, and office visits. Services provided by the registered
nurse include, but are not limited to, parent education, assistance and training in breast and
bottle feeding, and conducting any necessary and appropriate clinical tests. The home visit
must be conducted within four days following the discharge of the mother and her child.
Subd. 3.
Prohibition on cost sharing; limitations.
(a) Except as provided under
paragraph (b), the coverage required under this section must be provided without cost
sharing, including but not limited to deductible, co-pay, or coinsurance. The coverage
required under this section must be provided without any limitation that is not generally
applicable to other coverages under the plan.
(b) Coverage provided under this section to transfer a mother or newborn from one
medical facility to a different medical facility may be provided with cost sharing if the
transfer is not recommended by a health care provider.
Subd. 4.
Health plan defined.
For purposes of this section, "health plan" has the meaning
given in section 62Q.01, subdivision 3.
EFFECTIVE DATE.
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
Sec. 3.
Minnesota Statutes 2022, section 62A.047, is amended to read:
62A.047 CHILDREN'S HEALTH SUPERVISION SERVICES AND PRENATAL
CARE SERVICES.
Subdivision 1.
Coverage required.
A policy of individual or group health and accident
insurance regulated under this chapter, or individual or group subscriber contract regulated
under chapter 62C, health maintenance contract regulated under chapter 62D, or health
benefit certificate regulated under chapter 64B, issued, renewed, or continued to provide
coverage to a Minnesota resident, Each health plan, as defined in section 62Q.01, subdivision
3, must provide coverage for child health supervision services and prenatal care services.
The policy, contract, or certificate must specifically exempt reasonable and customary
charges for child health supervision services and prenatal care services from a deductible,
co-payment, or other coinsurance or dollar limitation requirement. This section does not
prohibit the use of policy waiting periods for these services. Minimum benefits may be
limited to one visit payable to one provider for all of the services provided at each visit cited
in this section subject to the schedule set forth in this section. Nothing in this section applies
to a commercial health insurance policy issued as a companion to a health maintenance
organization contract, a policy designed primarily to provide coverage payable on a per
diem, fixed indemnity, or nonexpense incurred basis, or a policy that provides only accident
coverage. A policy, contract, or certificate described under this section may not apply to
preexisting condition limitations to individuals under 19 years of age. This section does not
apply to individual coverage under a grandfathered plan. A health plan is prohibited from
limiting coverage under this section based on an individual's preexisting condition.
Subd. 2.
Prohibition on cost sharing; limitations.
The coverage required under this
section must be provided without cost sharing, including but not limited to deductible,
co-pay, or coinsurance. The coverage required under this section must be provided without
any limitation that is not generally applicable to other coverages under the plan.
Subd. 3.
Child health supervision services defined.
For purposes of this section, "child
health supervision services" means pediatric preventive services, appropriate immunizations,
developmental assessments, and laboratory services appropriate to the age of a child from
birth to age six, and appropriate immunizations from ages six to 18, as defined by Standards
of Child Health Care issued by the American Academy of Pediatrics. Reimbursement must
be made for at least five child health supervision visits from birth to 12 months, three child
health supervision visits from 12 months to 24 months, once a year from 24 months to 72
months.
Subd. 4.
Prenatal care services defined.
For purposes of this section, the term "prenatal
care services" means:
(1) the comprehensive package of medical and psychosocial support provided throughout
the pregnancy, including risk assessment, serial surveillance, prenatal education, and use
of specialized skills and technology, when needed, as defined by Standards for
Obstetric-Gynecologic Services issued by the American College of Obstetricians and
Gynecologists.; and
(2) all prenatal care of a mother and her child that is (i) recommended by a health care
provider acting within the provider's scope of practice, and (ii) related to the pregnancy,
delivery, and associated well-being of the mother and child. For purposes of this clause,
prenatal care includes but is not limited to all procedures, examinations, screenings,
counseling, education, and office visits.
EFFECTIVE DATE.
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
Sec. 4.
Minnesota Statutes 2022, section 62Q.521, is amended to read:
62Q.521 POSTNATAL CARE.
(a) For purposes of this section, "comprehensive postnatal visit" means a visit with a
health care provider that includes a full assessment of the mother's and infant's physical,
social, and psychological well-being, including but not limited to: mood and emotional
well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and
fatigue; physical recovery from birth; chronic disease management; and health maintenance.
(b) A health plan must provide coverage for the following:
(1) a comprehensive postnatal visit with a health care provider not more than three weeks
from the date of delivery;
(2) any postnatal visits recommended by a health care provider between three and 11
weeks from the date of delivery; and
(3) a comprehensive postnatal visit with a health care provider 12 weeks from the date
of delivery.; and
(4) all postnatal care of a mother and infant, prior to the infant reaching one year of age,
recommended by a health care provider acting within the provider's scope of practice,
including but not limited to all procedures, examinations, screenings, counseling, education,
and office visits.
(c) The requirements of this section are separate from and cannot be met by a visit made
pursuant to section 62A.0411.
(d) The coverage required under this section must be provided without cost sharing,
including but not limited to deductible, co-pay, or coinsurance. The coverage required under
this section must be provided without any limitation that is not generally applicable to other
coverages under the plan.
EFFECTIVE DATE.
This section is effective January 1, 2025, and applies to all policies,
plans, certificates, and contracts offered, issued, or renewed on or after that date.
Sec. 5. REPEALER.
Minnesota Statutes 2022, section 62A.041, subdivision 2,
is repealed.
EFFECTIVE DATE.
This section is effective January 1, 2025.
APPENDIX
Repealed Minnesota Statutes: 24-05492
62A.041 MATERNITY BENEFITS.
Subd. 2.
Limitation on coverage prohibited.
Each group policy of accident and health insurance, except for policies which only provide coverage for specified diseases, or each group subscriber contract of accident and health insurance or health maintenance contract, issued or renewed after August 1, 1987, shall include maternity benefits in the same manner as any other illness covered under the policy or contract.