Okla. Stat. tit. 36, § 36-6060.3: Maternity benefits - Postpartum care

A. Every health benefit plan issued, amended, renewed or

delivered in this state on or after July 1, 1996, that provides

maternity benefits shall provide for coverage of:

1. A minimum of forty-eight (48) hours of inpatient care at a

hospital, or a birthing center licensed as a hospital, following a

vaginal delivery, for the mother and newborn infant after

childbirth, except as otherwise provided in this section;

2. A minimum of ninety-six (96) hours of inpatient care at a

hospital following a delivery by caesarean section for the mother

and newborn infant after childbirth, except as otherwise provided in

this section; and

3. a. Postpartum home care following a vaginal delivery if

childbirth occurs at home or in a birthing center that

is not licensed as a hospital but that is accredited

as a freestanding birth center by the Commission for

the Accreditation of Birth Centers. The coverage

shall provide for one home visit within forty-eight

(48) hours of childbirth by a licensed health care

provider whose scope of practice includes providing

postpartum care. Visits shall include, at a minimum:

(1) physical assessment of the mother and the newborn

infant,

(2) parent education, to include, but not be limited

to:

(a) the recommended childhood immunization

schedule,

(b) the importance of childhood immunizations,

and

(c) resources for obtaining childhood

immunizations,

(3) training or assistance with breast or bottle

feeding, and

(4) the performance of any medically necessary and

appropriate clinical tests.

b. At the discretion of the mother, visits may occur at

the facility of the plan or the provider.

B. Inpatient care shall include, at a minimum:

1. Physical assessment of the mother and the newborn infant;

2. Parent education, to include, but not be limited to:

a. the recommended childhood immunization schedule,

b. the importance of childhood immunizations, and

c. resources for obtaining childhood immunizations;

3. Training or assistance with breast or bottle feeding; and

4. The performance of any medically necessary and appropriate

clinical tests.

C. A plan may limit coverage to a shorter length of hospital

inpatient stay for services related to maternity and newborn infant

care provided that:

1. In the sole medical discretion or judgment of the attending

physician licensed by the State Board of Medical Licensure and

Supervision or the State Board of Osteopathic Examiners or the

certified nurse midwife licensed by the Oklahoma Board of Nursing

providing care to the mother and to the newborn infant, it is

determined prior to discharge that an earlier discharge of the

mother and newborn infant is appropriate and meets medical criteria

contained in the most current treatment standards of the American

Academy of Pediatrics and the American College of Obstetricians and

Gynecologists that determine the appropriate length of stay based

upon:

a. evaluation of the antepartum, intrapartum and

postpartum course of the mother and newborn infant,

b. the gestational age, birth weight and clinical

condition of the newborn infant,

c. the demonstrated ability of the mother to care for the

newborn infant post-discharge, and

d. the availability of post-discharge follow-up to verify

the condition of the newborn infant in the first

forty-eight (48) hours after delivery.

A plan shall adopt these guidelines by July 1, 1996; and

2. The plan covers one home visit, within forty-eight (48)

hours of discharge, by a licensed health care provider whose scope

of practice includes providing postpartum care. The visits shall

include, at a minimum:

a. physical assessment of the mother and the newborn

infant,

b. parent education, to include, but not be limited to:

(1) the recommended childhood immunization schedule,

(2) the importance of childhood immunizations, and

forty-eight (48)

hours of discharge, by a licensed health care provider whose scope

of practice includes providing postpartum care. The visits shall

include, at a minimum:

a. physical assessment of the mother and the newborn

infant,

b. parent education, to include, but not be limited to:

(1) the recommended childhood immunization schedule,

(2) the importance of childhood immunizations, and

(3) resources for obtaining childhood immunizations,

c. training or assistance with breast or bottle feeding,

and

d. the performance of any medically necessary and

clinical tests.

At the mother’s discretion, visits may occur at the facility of

the plan or the provider.

D. The plan shall include, but is not limited to, notice of the

coverage required by this section in the evidence of coverage of the

plan, and shall provide additional written notice of the coverage to

the insured or an enrollee during the course of the prenatal care of

the insured or enrollee.

E. In the event the coverage required by this section is

provided under a contract that is subject to a capitated or global

rate, the plan shall be required to provide supplementary

reimbursement to providers for any additional services required by

that coverage if it is not included in the capitation or global

rate.

F. No health benefit plan subject to the provisions of this

section shall terminate the services of, reduce capitation payments

for, refuse payment for services, or otherwise discipline a licensed

health care provider who orders care consistent with the provisions

of this section.

G. As used in this section:

1. “Birthing center” has the same meaning as provided by

Section 1-701 of Title 63 of the Oklahoma Statutes; and

2. “Health benefit plan” means any plan or arrangement as

defined in subsection C of Section 6060.4 of this title.

H. The Insurance Commissioner shall promulgate any rules

necessary to implement the provisions of this section.