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26 U.S.C. § 9811 — Standards relating to benefits for mothers and newborns
Federal law — U.S. Code and appendices · legal_authorities
**(a) Requirements for minimum hospital stay following birth**
(1) **In general** — A group health plan may not—
(A) except as provided in paragraph (2)—
(i) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a normal vaginal delivery, to less than 48 hours, or
(ii) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a caesarean section, to less than 96 hours; or
(B) require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under subparagraph (A) (without regard to paragraph (2)).
(2) **Exception** — Paragraph (1)(A) shall not apply in connection with any group health plan in any case in which the decision to discharge the mother or her newborn child prior to the expiration of the minimum length of stay otherwise required under paragraph (1)(A) is made by an attending provider in consultation with the mother.
**(b) Prohibitions** A group health plan may not—
(1) deny to the mother or her newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section;
(2) provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section;
(3) penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an individual participant or beneficiary in accordance with this section;
(4) provide incentives (monetary or otherwise) to an attending provider to induce such provider to provide care to an individual participant o
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Source file: Laws/federal/codes/united-states-code/title-26/section-9811-standards-relating-to-benefits-for-mothers-and-newborns--cc80223944.md
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Source location: Title 26, Chapter 100, § 9811; chapter-100-group-health-plan-requirements.md
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**(a) Requirements for minimum hospital stay following birth**
(1) **In general** — A group health plan may not—
(A) except as provided in paragraph (2)—
(i) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a normal vaginal delivery, to less than 48 hours, or
(ii) restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child, following a caesarean section, to less than 96 hours; or
(B) require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under subparagraph (A) (without regard to paragraph (2)).
(2) **Exception** — Paragraph (1)(A) shall not apply in connection with any group health plan in any case in which the decision to discharge the mother or her newborn child prior to the expiration of the minimum length of stay otherwise required under paragraph (1)(A) is made by an attending provider in consultation with the mother.
**(b) Prohibitions** A group health plan may not—
(1) deny to the mother or her newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the plan, solely for the purpose of avoiding the requirements of this section;
(2) provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum protections available under this section;
(3) penalize or otherwise reduce or limit the reimbursement of an attending provider because such provider provided care to an individual participant or beneficiary in accordance with this section;
(4) provide incentives (monetary or otherwise) to an attending provider to induce such provider to provide care to an individual participant or beneficiary in a manner inconsistent with this section; or
(5) subject to subsection (c)(3), restrict benefits for any portion of a period within a hospital length of stay required under subsection (a) in a manner which is less favorable than the benefits provided for any preceding portion of such stay.
**(c) Rules of construction**
(1) Nothing in this section shall be construed to require a mother who is a participant or beneficiary—
(A) to give birth in a hospital; or
(B) to stay in the hospital for a fixed period of time following the birth of her child.
(2) This section shall not apply with respect to any group health plan which does not provide benefits for hospital lengths of stay in connection with childbirth for a mother or her newborn child.
(3) Nothing in this section shall be construed as preventing a group health plan from imposing deductibles, coinsurance, or other cost-sharing in relation to benefits for hospital lengths of stay in connection with childbirth for a mother or newborn child under the plan, except that such coinsurance or other cost-sharing for any portion of a period within a hospital length of stay required under subsection (a) may not be greater than such coinsurance or cost-sharing for any preceding portion of such stay.
**(d) Level and type of reimbursements** Nothing in this section shall be construed to prevent a group health plan from negotiating the level and type of reimbursement with a provider for care provided in accordance with this section.
**(e) Preemption; exception for health insurance coverage in certain States** The requirements of this section shall not apply with respect to health insurance coverage if there is a State law (including a decision, rule, regulation, or other State action having the effect of law) for a State that regulates such coverage that is described in any of the following paragraphs:
(1) Such State law requires such coverage to provide for at least a 48-hour hospital length of stay following a normal vaginal delivery and at least a 96-hour hospital length of stay following a caesarean section.
(2) Such State law requires such coverage to provide for maternity and pediatric care in accordance with guidelines established by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, or other established professional medical associations.
(3) Such State law requires, in connection with such coverage for maternity care, that the hospital length of stay for such care is left to the decision of (or required to be made by) the attending provider in consultation with the mother.
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Married individuals filing joint returns and surviving spouses** There is hereby imposed on the taxable income of—
(1) every married individual (as defined in section 7703) who makes a single return jointly with his spouse under section 6013, and
(2) every surviving spouse (as defined in section 2(a)),
a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $36,90015% of taxable income. Over $36,900 but not over $89,150$5,535, plus 28% of the excess over $36,900. Over $89,150 but not over $140,000$20,165, plus 31% of the excess over $89,150. Over $140,000 but not over $250,000$35,928.50, plus 36% of the excess over $140,000. Over $250,000$75,528.50, plus 39.6% of the excess over $250,000.
**(b) Heads of households** There is hereby imposed on the taxable income of every head of a household (as defined in section 2(b)) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $29,60015% of taxable income. Over $29,600 but not over $76,400$4,440, plus 28% of the excess over $29,600. Over $76,400 but not over $127,500$17,544, plus 31% of the excess over $76,400. Over $127,500 but not over $250,000$33,385, plus 36% of the excess over $127,500. Over $250,000$77,485, plus 39.6% of the excess over $250,000.
**(c) Unmarried individuals (other than surviving spouses and heads of households)** There is hereby imposed on the taxable income of every individual (other than a surviving spouse as defined in section 2(a) or the head of a household as defined in section 2(b)) who is not a married individual (as defined in section 7703) a tax determined in accordance with the following table: If taxable income is:The tax is: Not over $22,10015% of taxable income. Over $22,100 but not over $53,50
Source: Supplied U.S. Code snapshot — release unconfirmed · 26 U.S.C. § 1
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Federal law — U.S. Code and appendices · legal_authorities
**(a) Purpose** The purpose of this section is to enable the Secretary to ensure to the maximum extent feasible, in any emergency area and during an emergency period (as defined in subsection (g)(1))—
(1) that sufficient health care items and services are available to meet the needs of individuals in such area enrolled in the programs under subchapters XVIII, XIX, and XXI; and
(2) that health care providers (as defined in subsection (g)(2)) that furnish such items and services in good faith, but that are unable to comply with one or more requirements described in subsection (b), may be reimbursed for such items and services and exempted from sanctions for such noncompliance, absent any determination of fraud or abuse.
**(b) Secretarial authority** To the extent necessary to accomplish the purpose specified in subsection (a), the Secretary is authorized, subject to the provisions of this section, to temporarily waive or modify the application of, with respect to health care items and services furnished by a health care provider (or classes of health care providers) in any emergency area (or portion of such an area) during any portion of an emergency period, the requirements of subchapters XVIII, XIX, or XXI, or any regulation thereunder (and the requirements of this subchapter other than this section, and regulations thereunder, insofar as they relate to such subchapters), pertaining to—
(1)
(A) conditions of participation or other certification requirements for an individual health care provider or types of providers,
(B) program participation and similar requirements for an individual health care provider or types of providers, and
(C) pre-approval requirements;
(2) requirements that physicians and other health care professionals be licensed in the State
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 1320b–5
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Federal law — U.S. Code and appendices · legal_authorities
**(a) In general** Each group health plan and health insurance issuer offering group or individual health insurance coverage shall submit to the Secretary, jointly with the Secretary of Labor and the Secretary of the Treasury—
(1) not later than the date that is 90 days after the last day of the first calendar year beginning on or after the date on which a final rule is promulgated pursuant to the rulemaking described in section 106(d) of the No Surprises Act, the information described in subsection (b) with respect to such plan year; and
(2) not later than the date that is 90 days after the last day of the calendar year immediately succeeding the plan year described in paragraph (1), such information with respect to such immediately succeeding plan year.
**(b) Information described** For purposes of subsection (a), information described in this subsection, with respect to a group health plan or a health insurance issuer offering group or individual health insurance coverage, is each of the following:
(1) Claims data for air ambulance services furnished by providers of such services, disaggregated by each of the following factors:
(A) Whether such services were furnished on an emergent or nonemergent basis.
(B) Whether the provider of such services is part of a hospital-owned or sponsored program, municipality-sponsored program, hospital independent partnership (hybrid) program, independent program, or tribally operated program in Alaska.
(C) Whether the transport in which the services were furnished originated in a rural or urban area.
(D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services.
(E) Whether the provider of such services has a contract with the plan or issuer, as applicable, to furnish such
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 300gg–118
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Federal law — U.S. Code and appendices · legal_authorities
Page 4180
TITLE 26—INTERNAL REVENUE CODE
[§ 9804
1 No section 9814 has been enacted.
2 No section 9821 has been enacted.
Editorial Notes
REFERENCES IN TEXT
Section 3(40) of the Employee Retirement Income Se-
curity Act of 1974, referred to in subsec. (b), is classified
to section 1002(40) of Title 29, Labor.
The date of the enactment of this section, referred to
in subsec. (b), is the date of enactment of Pub. L.
104–191, which was approved Aug. 21, 1996.
Statutory Notes and Related Subsidiaries
EFFECTIVE DATE
Section applicable to plan years beginning after June
30, 1997, see section 401(c) of Pub. L. 104–191, set out as
a note under section 9801 of this title.
[§ 9804. Renumbered § 9831]
[§ 9805. Renumbered § 9832]
[§ 9806. Renumbered § 9833]
Subchapter B—Other Requirements
Sec.
9811.
Standards relating to benefits for mothers
and newborns.
9812.
Parity in mental health and substance use
disorder benefits.
9813.
Coverage of dependent students on medically
necessary leave of absence.
9815.
Additional market reforms.1
9816.
Preventing surprise medical bills.
9817.
Ending surprise air ambulance bills.
9818.
Continuity of care.
9819.
Maintenance of price comparison tool.
9820.
Protecting patients and improving the accu-
racy of provider directory information.
9822.
Other patient protections.2
9823.
Air ambulance report requirements.
9824.
Increasing transparency by removing gag
clauses on price and quality information.
9825.
Reporting on pharmacy benefits and drug
costs.
Editorial Notes
AMENDMENTS
2020—Pub. L. 116–260, div. BB, title I, §§ 102(c)(3),
105(a)(3)(B), 106(b)(3)(B), 113(b)(2), 114(b)(2), 116(d)(2),
title II, §§ 201(d)(2), 204(d)(2), Dec. 27, 2020, 134 Stat. 2796,
2851, 2855, 2871, 2874, 2887, 2894, 2922, adde
Source: Supplied 2024 U.S. Code historical extraction · 26 U.S.C. § 9811
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.