Links to CA Case Law regarding HB?

[thursday2]

Our insurance company denied our claim for an in-network exemption for home birth and denied our appeal. So now I'm on to taking it up with the state...grrr...

I've read multiple times that CA law stipulates that if an insurance plan covers maternity that they must therefore cover home birth, but does anyone have a link to that section of the law? I'd like to send it with my appeal letter. Thanks-

[frenchkissed]

I don't have a link for you, sorry. I live in NY, and our law says that insurance companies must cover licensed nurse-midwives. The location of the birth does not matter, it's the type of care provider. It still took a great amount of vigilance on my part for them to actually pay the correct benefits-- they pre-approved my "PPO Waiver" and stated that they would pay at the in-network rate (80%) once my $1k deductible was met, but when my midwife actually submitted the claim they paid only 50% of the Global fee which is the normal out-of-network amount. I called them and they said it was an oversight and corrected it immediately. I suspect it was not an oversight but routine for them, just hoping people don't check up! Then my midwife billed separately for my Rhogam injection and the newborn exam and tht made up enough that I only paid $1500 for my whole homebirth.

[nikirj]

Some states have an every-category-of-provider law.

I don't know how to go about it in CA, but here in Washington it is actually pretty easy to look up laws/regulations/administrative code through the government's own website; I don't know why, exactly, but I can find information directly on the site that google doesn't come up with no matter how good my search phrases are.

[cristeen]

Unless that's extremely recent, I don't believe that's true. I'm in CA and had to come out of pocket for my HB (in Sept). The birth would have cost me $0 OOP if I'd delivered in the hospital, but I paid $4500 for a HBMW. $0 reimbursement possible.