{"id":355831,"date":"2016-04-04T10:46:17","date_gmt":"2016-04-04T15:46:17","guid":{"rendered":"https:\/\/content.findlaw-admin.com\/ability-law\/healthcare\/patient-rights\/overview-of-the-newborns-and-mothers-health-protection-act.html"},"modified":"2023-07-22T11:56:24","modified_gmt":"2023-07-22T16:56:24","slug":"overview-of-the-newborns-and-mothers-health-protection-act","status":"publish","type":"page","link":"https:\/\/www.findlaw.com\/healthcare\/patient-rights\/overview-of-the-newborns-and-mothers-health-protection-act.html","title":{"rendered":"What is the Newborns&#8217; and Mothers&#8217; Health Protection Act?"},"content":{"rendered":"\n<div class=\"wp-container-core-columns-is-layout-9d6595d7 fl-sectionWithSidebar fl-container fl-flex fl-flex-wrap fl-gap30\">\n    \n    <div class=\"fl-page-articles fl-section-main fl-section-main-full-width\">\n        <h1 class=\"fl-no-margin-top\">What is the Newborns&#039; and Mothers&#039; Health Protection Act?<\/h1>\n<section class=\"fl-gutenberg-byline\">\n    <div class=\"fl-gutenberg-byline-content\">\n                    By <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/melissa-mccall-j-d\/\">Melissa McCall, J.D.<\/a> | Legally reviewed by <a\n                href=\"https:\/\/www.findlaw.com\/company\/our-team\/aviana-cooper-esq\/\">Aviana Cooper, Esq.<\/a>\n                | Last updated\n        <time>\n                            July 22, 2023\n                    <\/time>\n    <\/div>\n\n    \n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-legally-reviewed\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Legally Reviewed\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>This article has been written and reviewed for legal accuracy, clarity, and style by <a href=\"https:\/\/www.findlaw.com\/company\/our-team.html\">FindLaw\u2019s team of legal writers and attorneys<\/a> and in accordance with <a href=\"https:\/\/www.findlaw.com\/company\/company-history\/editorial-policy.html\">our editorial standards<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n\n    <details class=\"fl-gutenberg-byline-toggle fl-gutenberg-byline-fast-checked\">\n        <summary>\n            <i class=\"fl-gutenberg-byline-icon\" aria-hidden=\"true\"><\/i>\n            Fact-Checked\n        <\/summary>\n\n        <div class=\"fl-gutenberg-byline-toggle-content\">\n            <p><em>The last updated date refers to the last time this article was reviewed by FindLaw or one of our <a href=\"https:\/\/www.findlaw.com\/company\/our-team\/contributing-authors.html\">contributing authors<\/a>. We make every effort to keep our articles updated. For information regarding a specific legal issue affecting you, please <a href=\"https:\/\/lawyers.findlaw.com\/?fli=bylinelink\" target=\"_blank\" rel=\"noopener\">contact an attorney in your area<\/a>.<\/em><\/p>\n\n        <\/div>\n    <\/details>\n<\/section>\n<p>The&nbsp;<a href=\"https:\/\/www.cms.gov\/CCIIO\/Programs-and-Initiatives\/Other-Insurance-Protections\/nmhpa_factsheet\" target=\"_blank\" rel=\"noopener\">Newborns&#8217; and Mothers&#8217; Health Protection Act of 1996<\/a>&nbsp;(NMHPA) is a federal law that deals with how long a mother and newborn can stay in the hospital after birth. Under this public health law, some health insurance issuers must pay for hospital stays following delivery.<\/p>\r\n<p>The type of delivery determines the length of time you can stay in the hospital. For vaginal delivery, it is at least 48 hours. For cesarean sections, it is 96 hours. These periods begin at the time of delivery, not when the hospital admits the pregnant woman. Only the attending provider can discharge the mother and her newborn child before the time ends. The provider must consult the mother before discharge.<\/p>\r\n<p>This article explores the purpose of the NMHPA and examines a few of its regulations.<\/p>\r\n<h2>Purpose of the Newborns&#8217; and Mothers&#8217; Health Protection Act of 1996<\/h2>\r\n<p>New moms face many health conditions following labor requiring further medical care. Some of these conditions include the following:<\/p>\r\n<ul>\r\n<li>Incontinence<\/li>\r\n<\/ul>\r\n<ul>\r\n<li>Continued contractions<\/li>\r\n<\/ul>\r\n<ul>\r\n<li>Cesarean section wounds<\/li>\r\n<\/ul>\r\n<ul>\r\n<li>Uterine or breast infections<\/li>\r\n<\/ul>\r\n<ul>\r\n<li>Blood clots or heavy bleeding<\/li>\r\n<\/ul>\r\n<h3>Maternal Well-Being<\/h3>\r\n<p>Maternal well-being is an essential aspect of women&#8217;s health. Before Congress enacted this bill, health insurance companies pressured health care providers to quickly discharge mothers after birth. Often this was against their professional judgment.<\/p>\r\n<p>Early birth increases &quot;health risks for mothers and newborns.&quot; This includes&nbsp;<a href=\"https:\/\/www.congress.gov\/congressional-report\/104th-congress\/senate-report\/326\/1\" target=\"_blank\" rel=\"noopener\">preventable risks<\/a>, such as newborn jaundice. This also includes mental health conditions like postpartum depression. Maternity care and maternal well-being are not limited to the prenatal period.<\/p>\r\n<h3>Postpartum Care<\/h3>\r\n<p>Congress modeled the NMHPA after guidelines set forth by the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP). Allowing a minimum 48-hour stay ensures the mother and newborn receive adequate postpartum care.<\/p>\r\n<p>Maternal health care providers can screen the newborn child for metabolic and genetic disorders and educate the mother. They can also plan follow-up care based on test results. The minimum stay also allows health care providers to fulfill initiatives like breastfeeding.<\/p>\r\n<h2>Coverage Requirements<\/h2>\r\n<p>The&nbsp;<a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/ebsa\/about-ebsa\/our-activities\/resource-center\/faqs\/nmhpa.pdf\" target=\"_blank\" rel=\"noopener\">NMHPA<\/a>&nbsp;has a few unique rules. First, health insurance companies cannot provide incentives to the mother in exchange for not accepting all the benefits under the NMHPA. They cannot incentivize health care providers (including nurse midwives and physician assistants) to discharge mothers before the time is up. Pre-authorization for pregnant women is not necessary under the NMHPA.<\/p>\r\n<h2>Special Enrollment<\/h2>\r\n<p>A new birth or adoption triggers a special enrollment period. Special enrollment allows new parents or dependents to enroll in a new health care plan. If they enroll in their employer&#8217;s plan, they must&nbsp;<a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/ebsa\/about-ebsa\/our-activities\/resource-center\/faqs\/nmhpa.pdf\" target=\"_blank\" rel=\"noopener\">notify their plan<\/a>&nbsp;within 30 days of the birth or adoption. This timeframe doubles if they enroll in a health care plan on the Health Exchange Marketplace.<\/p>\r\n<h2>Health Insurance Portability and Accountability Act (HIPAA)<\/h2>\r\n<p>As with any health benefit plan, HIPAA protects your right to privacy. Unless there is an exception to HIPAA&#8217;s rules, your attending provider cannot share any information without your consent.<\/p>\r\n<h2>Health Care Plans Subject to the Newborns&#8217; Act<\/h2>\r\n<p>The NMHPA applies to health insurance coverage self-insured by the employment-based plan. State laws may offer similar protections if you get your insurance from an HMO.<\/p>\r\n<p>The Act applies to&nbsp;<a href=\"http:\/\/www.cms.gov\/CCIIO\/Programs-and-Initiatives\/Other-Insurance-Protections\/nmhpa_factsheet.html\" target=\"_blank\" rel=\"noopener\">two types of health insurance<\/a>:<\/p>\r\n<ol>\r\n<li>Group health plans (through an employer or union), and<\/li>\r\n<li>Individual health insurance plans (self-insured).<\/li>\r\n<\/ol>\r\n<p>The U.S. Department of Labor regulates private employer group health plans. The Centers for Medicare &amp; Medicaid Services (CMS) regulates state and local government plans. A State&#8217;s insurance department handles group health plans. It is the insurance company&#8217;s regulator. Your plan administrator can share the status of your plan.<\/p>\r\n<p>The Employee Retirement Income Security Act (<a href=\"https:\/\/www.findlaw.com\/employment\/wages-and-benefits\/erisa-and-healthcare-plan-enforcement.html\">ERISA<\/a>) enforces private employer-based health care plans.<\/p>\r\n<h3>Group Market<\/h3>\r\n<p>On Oct. 20, 2008, the Internal Revenue Service (IRS), the U.S. Department of Labor (USDOL), and the Department of Health and Human Services (HHS), together, issued interim final rules implementing the group market provisions of the NMHPA. Group market refers to group health insurance plans.<\/p>\r\n<h2>Cost-Sharing<\/h2>\r\n<p>If your hospital length of stay exceeds 48 or 96 hours, as outlined in the NMPHA, your share of the costs should stay the same. The&nbsp;<a href=\"https:\/\/www.federalregister.gov\/documents\/2008\/10\/20\/E8-24666\/final-rules-for-group-health-plans-and-health-insurance-issuers-under-the-newborns-and-mothers\" target=\"_blank\" rel=\"noopener\">Final Rules<\/a>&nbsp;for the NMHPA are clear on cost-sharing. Your health insurance provider can only charge up if your stay is within the stated hours. The cost-sharing rate must remain consistent throughout your entire stay.<\/p>\r\n<h2>Get Help<\/h2>\r\n<p>The Newborns&#8217; and Mother&#8217;s Health Protection Act provides health protection for mothers. Speak to an experienced&nbsp;<a href=\"https:\/\/lawyers.findlaw.com\/health-health-care-law\/?fli=dcta\" target=\"_blank\" rel=\"noopener\">local health care attorney<\/a>&nbsp;for help or guidance.<\/p>\r\n<div class=\"was-this-helpful\">\n    <div\n            class=\"was-this-helpful__question-container\"\n            aria-labelledby=\"was-this-helpful__question\"\n            role=\"group\"\n    >\n        <span\n                id=\"was-this-helpful__question\"\n                class=\"was-this-helpful__question fl-text-lg-bold\"\n        >Was this helpful?<\/span>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"Yes\"\n                value=\"yes\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">Yes<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" 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id=\"clip0_604_3418\">\n                            <rect width=\"22\" height=\"22\" fill=\"white\"><\/rect>\n                        <\/clipPath>\n                    <\/defs>\n                <\/svg>\n            <\/i>\n        <\/button>\n        <button\n                class=\"was-this-helpful__button fl-text-sm\"\n                aria-label=\"No\"\n                value=\"no\"\n        >\n            <span class=\"was-this-helpful__button-text fl-text-bold\">No<\/span>\n            <i class=\"was-this-helpful__button-icon\">\n                <svg width=\"22\" height=\"22\" viewBox=\"0 0 22 22\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <g id=\"thumbs-down\" clip-path=\"url(#clip0_604_3423)\">\n                        <path id=\"Vector\"\n                              d=\"M16 0.999995H18.67C19.236 0.989986 19.7859 1.18813 20.2154 1.55681C20.645 1.9255 20.9242 2.43905 21 3V10C20.9242 10.5609 20.645 11.0745 20.2154 11.4432C19.7859 11.8119 19.236 12.01 18.67 12H16M9.00003 14V18C9.00003 18.7956 9.3161 19.5587 9.87871 20.1213C10.4413 20.6839 11.2044 21 12 21L16 12V0.999995H4.72003C4.2377 0.994543 3.76965 1.16359 3.40212 1.47599C3.0346 1.78839 2.79235 2.22309 2.72003 2.7L1.34003 11.7C1.29652 11.9866 1.31586 12.2793 1.39669 12.5577C1.47753 12.8362 1.61793 13.0937 1.80817 13.3125C1.99842 13.5313 2.23395 13.7061 2.49846 13.8248C2.76297 13.9435 3.05012 14.0033 3.34003 14H9.00003Z\"\n                              stroke=\"#666666\" stroke-width=\"2\" stroke-linecap=\"round\" stroke-linejoin=\"round\"\/>\n                    <\/g>\n                    <defs>\n                        <clipPath id=\"clip0_604_3423\">\n                            <rect width=\"22\" height=\"22\" fill=\"white\"\/>\n                        <\/clipPath>\n                    <\/defs>\n                <\/svg>\n            <\/i>\n        <\/button>\n    <\/div>\n    <span class=\"was-this-helpful__taken-action fl-text-sm-bold\"><\/span>\n    <div 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for=\"was-this-helpful__radio-button--solved-problem\"\n                        >Solved my problem<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--other\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"positive-feedback\"\n                                value=\"Other\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--other\"\n                        >Other<\/label>\n                    <\/div>\n                <\/fieldset>\n            <\/div>\n            <div 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class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--missing-info\"\n                        >Missing the information I need<\/label>\n                    <\/div>\n                    <div class=\"fl-radio-button-field fl-flex was-this-helpful__feedback-form-title\">\n                        <input\n                                id=\"was-this-helpful__radio-button--complicated\"\n                                class=\"fl-radio-button-field-input\"\n                                type=\"radio\"\n                                name=\"negative-feedback\"\n                                value=\"Too complicated\"\n                        >\n                        <label\n                                class=\"fl-radio-button-field-label fl-text-sm was-this-helpful__radio-label\"\n                                for=\"was-this-helpful__radio-button--complicated\"\n                        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<\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>An overview of the Newborns&#8217; and Mothers&#8217; Health Protection Act that protects mothers&#8217; postpartum rights to stay in the hospital. 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