HIPAA Headaches are, I think, "old news" to the hospitals and physicians'
practices.  Certain compliance dates for these larger entities have come and
gone .... so staff members have already been sent off to the seminars, to
learn and report back.

But those of us in private practice (like me!) are just catching up with
HIPAA .... and I am still immersed in my own study of the regulations, to
determine how and when a little-ol'-one-LC-shop like mine must comply with
regulations intended for larger businesses like insurance cos. and
hospitals.

I commend to everyone:  but and read ILCA's publication "Reimbursement
Toolkit for Lactation Consultants."  It was published July 2002.  It
contains detailed history and discussion of reimbursement for lactation
services.

There is also a memo prepared for ILCA by a research firm engaged to
determine "specific coverage of lactation care and services association with
the new HCPCS code S9443 -  Lactation classes, non-physician provider, per
session."  While the memo does not address the lactation *consult*, there is
a detailed explanation of the mind-set of the payers (the insurance cos.),
and whether they will cover lactation services, given the changes triggered
by HIPAA.


Liz Brooks, JD, IBCLC
Wyndmoor, PA, USA




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