Let me say from a provider viewpoint - that to ensure moms who need rental-grade pumps get them, the practice of having the insurance pay the providers with no intermediary or responsibility on the part of the moms is a catch 22. ON the one hand, it's nice that moms can get what they need. On the other hand, if there is no money for the providers to pay for the pumps, pay for the office costs, pay for the providers to actually have a job to provide, clean, instruct on the pumps, then the service goes away. Years ago I worked in a hospital that rented breast pumps and attempted to bill insurance companies for the rentals. Most of the time, we didn't get paid by the insurance company. Half the time, the renters didn't return the pumps. WE lost money. This is why DME's are reluctant to carry rental pumps and are happy to hand out the lowest cost pumps they can get regardless of the needs of the moms. Moms who need pumps to support breastfeeding until their babies can adequately nurse still will have to pay out of pocket to get what they need, IF they can find someone willing to risk their money to buy the pumps and rent them out. Ask Rachel Myr if the country she lives in provides free breast pumps on their health plans. My son just came back from working in Jamaica (not the tourist industry). No free breast pumps there either, although they do have free public health care. Do they have free breast pumps in Cuba? How about Canada? I have not seen insurance companies really stepping up to the plate to provide adequate coverage for lactation consultant services either. There may be a few LC's out there that are self-supporting with their practice - meaning they can pay rent and support themselves and families without being subsidized by working for a hospital or a doctor's office or a working husband or another job - but I bet they are few and far between. So once again it is the folks with the best financial resources who can get the best care.
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Marsha Walker
Sent: Tuesday, August 06, 2013 8:41 AM
Subject: Affordable Care Act and Breast Pumps
Kerry has asked about the Affordable Care Act (ACA) and breast pumps. The United States Lactation Consultant Association (USLCA) has received MANY reports regarding inappropriate breast pumps being issued by insurers, delays in obtaining a pump, and mass confusion among payers over how to interpret the ACA's mandate on breastfeeding equipment. Since the Department of Health and Human Services has issued no guidelines for insurers, the United States Breastfeeding Committee (USBC) and the National Breastfeeding Center (NBfC) collaborated to develop recommendations. The resulting joint publication, *Model Policy: Payer Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies*<http://www.usbreastfeeding.org/LinkClick.aspx?link=344&tabid=345>,
identifies best practices for payers that appropriately meet the requirements of the ACA and ensure adequate delivery of support for breastfeeding. The *Model Policy* was drafted in a collaborative effort with medical, legal, regulatory, lactation, public health, and insurance experts.
I had the privilege of contributing to this document which can be found at http://www.usbreastfeeding.org/Portals/0/Publications/Model-Policy-Payer-Coverage-Breastfeeding-Support.pdf.
This is a model of what payers should cover under the ACA and can be shared with every insurer in your state. Lactnetters can send this to insurers in their state, explaining that these guidelines represent evidence-based best practices. If mothers are complaining about problems with pumps or with accessing lactation care and services then have them send this model policy to their insurer too.
Marsha Walker, RN, IBCLC
Weston, MA
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