NJ Admin Code §11:24-5.2(a)(3)

October 15, 2021 5:31 am | Published by

(a) The HMO shall provide or arrange for the provision of the following basic comprehensive health services as medically necessary:

(3) Prenatal care and obstetric care:

(i) In accordance with 26:2J-4.9, obstetric care includes 48 hours of inpatient care following a vaginal delivery or a minimum of 96 hours of inpatient care following a caesarean section.

(ii) Notwithstanding the provisions of (a)3i above, a member agreement that provides health care services for post-delivery care to a mother and her newly born child in the home shall not be required to provide for a minimum of 48 hours and 96 hours, respectively, of inpatient care unless such inpatient care is determined to be medically necessary by the attending physician or is requested by the mother.

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