{"data":{"id":"us-ok/okla.-stat.-tit.-36-36-6060.3","jurisdiction":"us-ok","citation":"Okla. Stat. tit. 36, § 36-6060.3","heading":"Maternity benefits - Postpartum care","body":"A. Every health benefit plan issued, amended, renewed or\n\ndelivered in this state on or after July 1, 1996, that provides\n\nmaternity benefits shall provide for coverage of:\n\n1. A minimum of forty-eight (48) hours of inpatient care at a\n\nhospital, or a birthing center licensed as a hospital, following a\n\nvaginal delivery, for the mother and newborn infant after\n\nchildbirth, except as otherwise provided in this section;\n\n2. A minimum of ninety-six (96) hours of inpatient care at a\n\nhospital following a delivery by caesarean section for the mother\n\nand newborn infant after childbirth, except as otherwise provided in\n\nthis section; and\n\n3. a. Postpartum home care following a vaginal delivery if\n\nchildbirth occurs at home or in a birthing center that\n\nis not licensed as a hospital but that is accredited\n\nas a freestanding birth center by the Commission for\n\nthe Accreditation of Birth Centers. The coverage\n\nshall provide for one home visit within forty-eight\n\n(48) hours of childbirth by a licensed health care\n\nprovider whose scope of practice includes providing\n\npostpartum care. Visits shall include, at a minimum:\n\n(1) physical assessment of the mother and the newborn\n\ninfant,\n\n(2) parent education, to include, but not be limited\n\nto:\n\n(a) the recommended childhood immunization\n\nschedule,\n\n(b) the importance of childhood immunizations,\n\nand\n\n(c) resources for obtaining childhood\n\nimmunizations,\n\n(3) training or assistance with breast or bottle\n\nfeeding, and\n\n(4) the performance of any medically necessary and\n\nappropriate clinical tests.\n\nb. At the discretion of the mother, visits may occur at\n\nthe facility of the plan or the provider.\n\nB. Inpatient care shall include, at a minimum:\n\n1. Physical assessment of the mother and the newborn infant;\n\n2. Parent education, to include, but not be limited to:\n\na. the recommended childhood immunization schedule,\n\nb. the importance of childhood immunizations, and\n\nc. resources for obtaining childhood immunizations;\n\n3. Training or assistance with breast or bottle feeding; and\n\n4. The performance of any medically necessary and appropriate\n\nclinical tests.\n\nC. A plan may limit coverage to a shorter length of hospital\n\ninpatient stay for services related to maternity and newborn infant\n\ncare provided that:\n\n1. In the sole medical discretion or judgment of the attending\n\nphysician licensed by the State Board of Medical Licensure and\n\nSupervision or the State Board of Osteopathic Examiners or the\n\ncertified nurse midwife licensed by the Oklahoma Board of Nursing\n\nproviding care to the mother and to the newborn infant, it is\n\ndetermined prior to discharge that an earlier discharge of the\n\nmother and newborn infant is appropriate and meets medical criteria\n\ncontained in the most current treatment standards of the American\n\nAcademy of Pediatrics and the American College of Obstetricians and\n\nGynecologists that determine the appropriate length of stay based\n\nupon:\n\na. evaluation of the antepartum, intrapartum and\n\npostpartum course of the mother and newborn infant,\n\nb. the gestational age, birth weight and clinical\n\ncondition of the newborn infant,\n\nc. the demonstrated ability of the mother to care for the\n\nnewborn infant post-discharge, and\n\nd. the availability of post-discharge follow-up to verify\n\nthe condition of the newborn infant in the first\n\nforty-eight (48) hours after delivery.\n\nA plan shall adopt these guidelines by July 1, 1996; and\n\n2. The plan covers one home visit, within forty-eight (48)\n\nhours of discharge, by a licensed health care provider whose scope\n\nof practice includes providing postpartum care. The visits shall\n\ninclude, at a minimum:\n\na. physical assessment of the mother and the newborn\n\ninfant,\n\nb. parent education, to include, but not be limited to:\n\n(1) the recommended childhood immunization schedule,\n\n(2) the importance of childhood immunizations, and\nforty-eight (48)\n\nhours of discharge, by a licensed health care provider whose scope\n\nof practice includes providing postpartum care. The visits shall\n\ninclude, at a minimum:\n\na. physical assessment of the mother and the newborn\n\ninfant,\n\nb. parent education, to include, but not be limited to:\n\n(1) the recommended childhood immunization schedule,\n\n(2) the importance of childhood immunizations, and\n\n(3) resources for obtaining childhood immunizations,\n\nc. training or assistance with breast or bottle feeding,\n\nand\n\nd. the performance of any medically necessary and\n\nclinical tests.\n\nAt the mother’s discretion, visits may occur at the facility of\n\nthe plan or the provider.\n\nD. The plan shall include, but is not limited to, notice of the\n\ncoverage required by this section in the evidence of coverage of the\n\nplan, and shall provide additional written notice of the coverage to\n\nthe insured or an enrollee during the course of the prenatal care of\n\nthe insured or enrollee.\n\nE. In the event the coverage required by this section is\n\nprovided under a contract that is subject to a capitated or global\n\nrate, the plan shall be required to provide supplementary\n\nreimbursement to providers for any additional services required by\n\nthat coverage if it is not included in the capitation or global\n\nrate.\n\nF. No health benefit plan subject to the provisions of this\n\nsection shall terminate the services of, reduce capitation payments\n\nfor, refuse payment for services, or otherwise discipline a licensed\n\nhealth care provider who orders care consistent with the provisions\n\nof this section.\n\nG. As used in this section:\n\n1. “Birthing center” has the same meaning as provided by\n\nSection 1-701 of Title 63 of the Oklahoma Statutes; and\n\n2. “Health benefit plan” means any plan or arrangement as\n\ndefined in subsection C of Section 6060.4 of this title.\n\nH. The Insurance Commissioner shall promulgate any rules\n\nnecessary to implement the provisions of this section.","path":["OK Code","Title 36"],"source_url":"https://www.oklegislature.gov/OK_Statutes/CompleteTitles/os36.pdf","current_through":"2026-08-14","vintage":"open-us-law v2026.08, retrieved 2026-09-14","retrieved_at":"2026-09-14T18:32:36Z","sha256":"5909e3978bff377b6825c8d6bb403c9f7792f7d446e71c848f9066a6002a0a45","source_id":"us-ok","stale":false,"prev":"us-ok/okla.-stat.-tit.-36-36-6060.22","next":"us-ok/okla.-stat.-tit.-36-36-6060.30"},"notice":"GroundRules: Original legal text. Not legal advice."}