{"data":{"id":"us-ky/krs-304.17a-145","jurisdiction":"us-ky","citation":"KRS 304.17A-145","heading":"Maternity coverage to include specified services and amounts of","body":"inpatient care for mothers and newly born children -- Exemption.\n(1) As used in this section:\n(a) \"Health benefit plan\" has the same meaning as in KRS 304.17A -005, except\nfor purposes of this section, the term:\n1. Includes student health insurance offered by a Kentucky-licensed insurer\nunder written contract with a university or college whose students it\nproposes to insure; and\n2. Does not include a group health benefit plan that provides grandfathered\nhealth plan coverage as defined in 45 C.F.R. sec. 147.140(a), as\namended;\n(b) \"In-home program\" means a program offered by a health care facility or\nhealth care professional for the treatment of substance use disorder which  the\ninsured accesses through telehealth or digital health services; and\n(c) \"Telehealth\" or \"digital health\" has the same meaning as in KRS 211.332.\n(2) Except as provided for in subsection (5) of this section:\n(a) A health benefit plan shall provide maternity coverage; and\n(b) The coverage required by this subsection includes coverage for:\n1. All individuals covered under the plan, including dependents, regardless\nof age;\n2. Maternity care associated with pregnancy, childbirth, and postpartum\ncare;\n3. Labor and delivery;\n4. All breastfeeding services and supplies required under 42 U.S.C. sec.\n300gg-13(a) and any related federal regulations, as amended; and\n5. Except as provided in subsection (3) of this section, inpatient care for a\nmother and her newly born child for a minimum of:\na. Forty-eight (48) hours after vaginal delivery; or\nb. Ninety-six (96) hours after delivery by Cesarean section.\n(3) The provisions of subsection ( 2)(b)5. of this section shall not apply to a health\nbenefit plan if:\n(a) The plan authorizes an initial postpartum home visit which would include the\ncollection of an adequate sample for the hereditary and metabolic newborn\nscreening; and\n(b) The attending  physician, with the consent of the mother of the newly born\nchild, authorizes a shorter length of stay upon the physician's determination\nthat the mother and newborn meet the criteria for medical stability in the most\ncurrent version of \"Guidelines for Pe rinatal Care\" prepared by the American\nAcademy of Pediatrics and the American College of Obstetricians and\nGynecologists.\n(4) Except as provided for in subsection (5) of this section, a health benefit plan shall\nprovide coverage:\n(a) To pregnant and postpartum women for an in-home program; and\n(b) For telehealth or digital health services that are related to maternity care\nassociated with pregnancy, childbirth, and postpartum care.\n(5) If the application of any requirement of this section to a qualified hea lth plan as\ndefined in 42 U.S.C. sec. 18021(a)(1), as amended, would result in a determination\nthat the state must make payments to defray the cost of the requirement under 42\nU.S.C. sec. 18031(d)(3) and 45 C.F.R. sec. 155.170, as amended, then the\nrequirement shall not apply to the qualified health plan until the cost defrayal\nrequirement is no longer applicable.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=55801","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:46Z","sha256":"bf0bb4178eeaa9c7cd6fcffd7b11f65f850d2ce9d272bb6c0b92a6e1fa718af5","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-144","next":"us-ky/krs-304.17a-146"},"notice":"GroundRules: Original legal text. Not legal advice."}