NMHPA Coverage Requirements
NMHPA requires group health plans to cover at least 48 hours of hospital stay after a vaginal delivery and 96 hours after a cesarean delivery. Plans cannot require prior authorization for the minimum hospital stay. Plans can offer incentives for early discharge — but cannot penalize mothers or newborns for using the full minimum stay.
Notice Requirements
Plans must provide an NMHPA notice at enrollment. The notice must describe the NMHPA coverage requirements. The notice can be included in the SPD or as a standalone document. Unlike the WHCRA notice, the NMHPA notice is not required annually — only at enrollment.
Prior Authorization Prohibition
Compliance Note
Plans cannot require prior authorization for the NMHPA minimum hospital stay. A plan that requires prior authorization for a 48-hour vaginal delivery stay is violating NMHPA. Review your plan's prior authorization requirements for maternity care to confirm compliance.