Sec. 1366.055. COVERAGE FOR INPATIENT CARE REQUIRED. (a) Except as provided by Subsection (b), a health benefit plan that provides maternity benefits, including benefits for childbirth, must provide to a woman who has given birth to a child and the newborn child coverage for inpatient care in a health care facility for not less than:
(1) 48 hours after an uncomplicated vaginal delivery; and
(2) 96 hours after an uncomplicated delivery by cesarean section.
(b) A health benefit plan that provides to a woman who has given birth to a child and the newborn child coverage for in-home postdelivery care is not required to provide the coverage required under Subsection (a) unless:
(1) the attending physician determines that inpatient care is medically necessary; or
(2) the woman requests inpatient care.
(c) For purposes of Subsection (a), the attending physician shall determine whether a delivery is complicated.
(d) This section does not require a woman who is eligible for coverage under a health benefit plan to:
(1) give birth to a child in a hospital or other health care facility; or
(2) remain under inpatient care in a hospital or other health care facility for any fixed term following the birth of a child.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
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