I know that in California at least many times it is reimbursement related as our 
state Medi-cal will only reimburse lactation services that were provided by and 
RN, RD (or above) under a physician as an OP and in house I understand that 
this is the case as well (except you do not work under 1 physician per se)...I 
think it is sad, especially in CA where I know great LC's (with any initials) that 
are not either of those and they cannot see these patients which means they 
all go to WIC or a private practice that provides someone that meets the 
standards....hmm and WIC is overworked why?? Kind of ironic since most of my 
mothers insurance plans will not even pay for a pump unless the baby is still in 
the hospital and even then it can be a fight...Medi-cal will pay but only to the 
right persons.
Emily Lindsey, BSPsy, CLE
Private Practice
Merced, CA

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