I
105TH CONGRESS
1ST SESSION
H. R. 2854
To amend the Public Health Service Act, the Employee Retirement Income
Security Act of 1974, and the Internal Revenue Code of 1986 to require
group health plans and group and individual health insurance coverage
to provide post-delivery follow-up care for mothers and newborns dis-
charged less than 48 hours following a vaginal delivery or less than
96 hours following a delivery by cesarean section.
IN THE HOUSE OF REPRESENTATIVES
NOVEMBER 6, 1997
Mr. LATOURETTE (for himself, Mr. MILLER of California, Mrs. MORELLA,
Mr. DINGELL, Mr. SOLOMON, Ms. DELAURO, Ms. EDDIE BERNICE
JOHNSON of Texas, Mr. MCHUGH, Mr. GEJDENSON, Mrs. KELLY, Mr.
BALDACCI, Mr. FOLEY, Mr. NADLER, Mr. NETHERCUTT, Mr. FRANK of
Massachusetts, Mr. DEFAZIO, Mrs. THURMAN, Mr. MANTON, Mr.
SERRANO, Ms. BROWN of Florida, Ms. WOOLSEY, Mr. ACKERMAN, Ms.
RIVERS, Ms. LOFGREN, Mr. VENTO, Mr. EVANS, Mrs. MALONEY of New
York, Mr. GUTIERREZ, Mr. BORSKI, Mr. GREEN, and Mrs. MINK of Ha-
waii) introduced the following bill; which was referred to the Committee
on Commerce, and in addition to the Committees on Education and the
Workforce, and Ways and Means, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To amend the Public Health Service Act, the Employee Re-
tirement Income Security Act of 1974, and the Internal
Revenue Code of 1986 to require group health plans
and group and individual health insurance coverage to
provide post-delivery follow-up care for mothers and
newborns discharged less than 48 hours following a vagi-
nal delivery or less than 96 hours following a delivery
by cesarean section.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. REQUIREMENT FOR POST-DELIVERY FOLLOW-
UP CARE FOR EARLY HOSPITAL DISCHARGES
AFTER CHILDBIRTH.
(a) PUBLIC HEALTH SERVICE ACT AMENDMENT.—
(1) 
GROUP
HEALTH
COVERAGE.—Section
2704(a) of the Public Health Service Act (42 U.S.C.
300gg–4(a)) is amended—
(A) in paragraph (2), by striking ‘‘Para-
graph’’ and inserting ‘‘Subject to paragraph
(3), paragraph’’, and
(B) by adding at the end the following new
paragraph:
‘‘(3) REQUIRING COVERAGE OF POST-DELIVERY
FOLLOW-UP CARE.—
‘‘(A) IN GENERAL.—In the case of a deci-
sion described in paragraph (2) (relating to
early discharge), the group health plan or
health insurance issuer offering the coverage
shall provide coverage for timely post-delivery
care in any of the following settings (as selected
by the mother): the mother’s home, a provider’s
office, a hospital, a federally qualified health
center, a federally qualified rural health clinic,
a State health department maternity clinic, or
another setting (which may include a birthing
center or an intermediate care facility) deter-
mined appropriate under regulations promul-
gated by the Secretary.
‘‘(B) TIMELY CARE.—For purposes of sub-
paragraph (A), the term ‘timely post-delivery
care’ means health care that is provided—
‘‘(i) to a mother and her newborn
child following the discharge of a mother
and her newborn child from the hospital;
‘‘(ii) by a registered nurse, physician
(as defined in section 1861(r)(1) of the So-
cial Security Act), nurse practitioner,
nurse midwife, or physician assistant expe-
rienced in maternal and child health, as se-
lected by the mother; and
‘‘(iii) in a manner that meets the
health care needs of the mother and her
newborn child, that provides for the appro-
priate monitoring of the conditions of the
mother and child, and that occurs within
72 hours following discharge.
‘‘(C) CONSISTENCY
WITH
STATE
LAW.—
The Secretary shall, with respect to regulations
promulgated under to carry out this paragraph
and concerning appropriate post-delivery care
settings, ensure that, to the extent practicable,
such regulations are consistent with State li-
censing and practice laws.’’.
(2) APPLICATION TO INDIVIDUAL HEALTH IN-
SURANCE
COVERAGE.—The amendments made by
paragraph (1) apply to health insurance coverage in
the individual market under section 2751(a) of the
Public Health Service Act (42 U.S.C. 300gg–51).
(b) ERISA AMENDMENTS.—Section 711(a) of the
Employee Retirement Income Security Act of 1974 (29
U.S.C. 1185(a)) is amended—
(1) in paragraph (2), by striking ‘‘Paragraph’’
and inserting ‘‘Subject to paragraph (3), para-
graph’’, and
(2) by adding at the end the following new
paragraph:
‘‘(3) REQUIRING COVERAGE OF POST-DELIVERY
FOLLOW-UP CARE.—
‘‘(A) IN GENERAL.—In the case of a deci-
sion described in paragraph (2) (relating to
early discharge), the group health plan or
health insurance issuer offering the coverage
shall provide coverage for timely post-delivery
care in any of the following settings (as selected
by the mother): the mother’s home, a provider’s
office, a hospital, a federally qualified health
center, a federally qualified rural health clinic,
a State health department maternity clinic, or
another setting (which may include a birthing
center or an intermediate care facility) deter-
mined appropriate under regulations promul-
gated by the Secretary.
‘‘(B) TIMELY CARE.—For purposes of sub-
paragraph (A), the term ‘timely post-delivery
care’ means health care that is provided—
‘‘(i) to a mother and her newborn
child following the discharge of a mother
and her newborn child from the hospital;
‘‘(ii) by a registered nurse, physician
(as defined in section 1861(r)(1) of the So-
cial Security Act), nurse practitioner,
nurse midwife, or physician assistant expe-
rienced in maternal and child health, as se-
lected by the mother; and
‘‘(iii) in a manner that meets the
health care needs of the mother and her
newborn child, that provides for the appro-
priate monitoring of the conditions of the
mother and child, and that occurs within
72 hours following discharge.
‘‘(C) CONSISTENCY
WITH
STATE
LAW.—
The Secretary shall, with respect to regulations
promulgated under to carry out this paragraph
and concerning appropriate post-delivery care
settings, ensure that, to the extent practicable,
such regulations are consistent with State li-
censing and practice laws.’’.
(c) INTERNAL REVENUE CODE OF 1986 AMEND-
MENT.—Section 9811 of the Internal Revenue Code of
1986, as inserted by section 1531(a)(4) of the Taxpayer
Relief Act of 1997, is amended—
(1) in paragraph (2), by striking ‘‘Paragraph’’
and inserting ‘‘Subject to paragraph (3), para-
graph’’, and
(2) by adding at the end the following new
paragraph:
‘‘(3) REQUIRING COVERAGE OF POST-DELIVERY
FOLLOW-UP CARE.—
‘‘(A) IN GENERAL.—In the case of a deci-
sion described in paragraph (2) (relating to
early discharge), the group health plan or
health insurance issuer offering the coverage
shall provide coverage for timely post-delivery
care in any of the following settings (as selected
by the mother): the mother’s home, a provider’s
office, a hospital, a federally qualified health
center, a federally qualified rural health clinic,
a State health department maternity clinic, or
another setting (which may include a birthing
center or an intermediate care facility) deter-
mined appropriate under regulations promul-
gated by the Secretary.
‘‘(B) TIMELY CARE.—For purposes of sub-
paragraph (A), the term ‘timely post-delivery
care’ means health care that is provided—
‘‘(i) to a mother and her newborn
child following the discharge of a mother
and her newborn child from the hospital;
‘‘(ii) by a registered nurse, physician
(as defined in section 1861(r)(1) of the So-
cial Security Act), nurse practitioner,
nurse midwife, or physician assistant expe-
rienced in maternal and child health, as se-
lected by the mother; and
‘‘(iii) in a manner that meets the
health care needs of the mother and her
newborn child, that provides for the appro-
priate monitoring of the conditions of the
mother and child, and that occurs within
72 hours following discharge.
‘‘(C) CONSISTENCY
WITH
STATE
LAW.—
The Secretary shall, with respect to regulations
promulgated under to carry out this paragraph
and concerning appropriate post-delivery care
settings, ensure that, to the extent practicable,
such regulations are consistent with State li-
censing and practice laws.’’.
(d) EFFECTIVE DATES.—
(1) IN GENERAL.—Subject to paragraph (2),
the amendments made by this section shall apply
with respect to—
(A) group health plans, and health insur-
ance coverage offered in connection with group
health plans, for plan years beginning after
January 1, 1999; and
(B) health insurance coverage offered,
sold, issued, renewed, in effect, or operated in
the individual market after such date.
(2) SPECIAL RULE FOR COLLECTIVE BARGAIN-
ING AGREEMENTS.—In the case of a group health
plan maintained pursuant to one or more collective
bargaining agreements between employee representa-
tives and one or more employers ratified before the
date of the enactment of this Act, the amendments
made by this section shall not apply to plan years
beginning before the later of—
(A) the date on which the last of the col-
lective bargaining agreements relating to the
plan terminates (determined without regard to
any extension thereof agreed to after the date
of the enactment of this Act), or
(B) January 1, 1999.
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining
agreement relating to the plan which amends the
plan solely to conform to any requirement imposed
under an amendment made by this Act shall not be
treated as a termination of such collective bargain-
ing agreement.
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