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Date: | Tue, 31 Jul 2012 08:54:24 -0500 |
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Here is the reimbursement rate I have seen: for Medicaid - $20.00. For insurance companies, $67.00 or 47.00. That's for 90 minutes. Enjoy. And try living off that. And if I understand the principles right, you can't bill for any supplies outside of that.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Marsha Walker
Sent: Monday, July 30, 2012 7:40 AM
Subject: USLCA Licensure and Reimbursement Committee
The United States Lactation Consultant Association (USLCA) was approached by Aetna, a large insurance company who covers 100,000 births per year in the US. They are creating a network of IBCLCs whom they will reimburse for providing lactation services in order to fulfill the requirements of the Affordable Care Act to cover such services with no cost sharing to the patient. The IBCLC does not need to be licensed. The IBCLC credential was chosen by a medical director at Aetna as the preferred credential based on its stringent requirements to achieve the credential. There are 2 webinars being planned to help educate any IBCLC who wises to become part of the Aetna network of providers. The first will be an introductory webinar which will explain the basics of reimbursement by an insurance carrier and the second will be conducted by Aetna to walk interested IBCLCs through the Aetna credentialing process. The introductory webinar has tentatively been planned for August 7 at 1:00pm eastern time. Members of USLCA will receive an email with the details of both webinars.
IBCLCs are not required to become a provider in the Aetna network. Other insurers will also be looking to reimburse for breastfeeding services too.
USLCA has sent a letter to approximately 250 of the largest insurers in the US reminding them that IBCLCs are uniquely qualified to help insurers meet the ACA requirements. Aetna sets the amount of reimbursement for IBCLC services to their members based on the area of the country in which the IBCLC practices. You do not need to become a preferred provider if you do not wish to. Aetna does not set your fees for other clients.
Many IBCLCs may wish to join this network as it will increase your client base, market your services to a large number of mothers, and provide services for mothers who cannot afford to pay out of pocket for IBCLC services. There are many mothers whose only access to the level of care that they need is if an IBCLC takes her Aetna insurance. Otherwise her baby may be weaned to formula and not receive his/her mother's milk.
Judy Gutowski, the chair of the USLCA Licensure and Reimbursement Committee is preparing a Q and A document that will begin to answer some of your questions. It will be available on the USLCA website soon. Please feel free to contact Judy or myself if you have more questions.
Marsha Walker, RN, IBCLC
Director of Public Policy, USLCA
Weston, MA
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