If they say LC covered under hospital - all that means is they will demand hospitals provide inpatient lactation services and inpatient pumps at no charge to the patient. Which is happening now.  Which does not mean that hospitals have to have a certain level of staffing unless perinatal guidelines are mandated and tied to accreditation. If they say they will cover outpatient consultations etc, that means there HAS to be some type of designated codes for lactation (CPT and HCPCS codes) that are not fudging and stealing from other uses.  The current codes being recommended are NOT adequate and do not get hospitals paid for providing outpatient services.  We have these at our hospital but the budget runs 350% in the red. Anyone who says they are making a profit are probably not looking closely at actual revenue per expense.  Hospitals pay for consultants salaries and benefits and overhead for offices and supplies. Then are required to bill under UB-92 forms with revenue codes that classify lactation as education which gets routinely denied by insurance companies.  There is not a good category that covers what LC's really do. We are seeing 2 clients - the mother AND the baby.  We don't spend 15 minutes and move on to the next patient. It is time, labor and thought intensive work as well as emotional, psychological and social therapy.  Only those who've benefited from the service truly understand what happens, IMHO.  As I prepare to hang up my working shoes and leave this field, I am sad to say things have not progressed on the financial end as I had hoped. And I am sorry to see the beating that Medela has received AND Prolacta who have invested millions of dollars of either venture capitalists or profits or family money into research to create products that are needed for many moms and babies to succeed at breastfeeding. Yes, they are just companies, not people, and they have a motive that is more animal than human (to grow and survive).  I will be taking boards one last time just to complete my life-cycle as an LC in 2012.  Hopefully, I will be allowed to do so under whatever the new rules become.  I have had a good career over all. And I'm ready to move on to being fulltime grandmother. I only hope that those that follow me will have passion for the field, and get respect that is deserved.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Dana Lauducci
Sent: Monday, August 01, 2011 12:45 PM
Subject: New health insurance lactation coverage

I've seen some links on Facebook referring to the new regulations for women's health preventative care coverage.

http://www.hrsa.gov/womensguidelines/

Can someone with more insurance background help me understand what this really means for the average mom? I'm sure I'm going to get some questions at my LLL meeting this week. Does it just means that lactation services are covered in conjunction with hospital birth services? Or does it mean that LC services and pump rentals will be covered by insurance at any time? What are the implications of that for private practice LCs?

Thanks for any background you can provide.

Dana Lauducci
LLLL, Branchburg NJ

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome