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Lactation Information and Discussion <[log in to unmask]>
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Tue, 15 Jun 2010 11:55:42 -0500
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Well - so far, the ruling has been that hospital visits by LC's cannot be billed to insurance companies.  It is considered a "nursing service" that should be part of the daily bill, at least in this state.  That is the ruling at this point from our revenue integrity officers.  So unless a patient contracts privately with an lc and pays them out of pocket to come to the hospital, I don't see how this will fly.  Everyone wants someone to pay for lactation services.  But I suspect until whoever is holding the pursestrings and pays for the alternative decides that lactation services are more economical than buying formula and its consequences, it will be up to the individual.  Lactation services is seen on the same level as cosmetic surgery by most insurers. Hey babies do perfectly fine on formula, why mess with that?  (Sarcasm intended).  I hear from so many parents that the first thing told a mom whose baby is not to birth weight at two weeks is just give the baby a bottle and formula.  No referral to an LC.  And moms who see an LC in the hospital think they've learned all there is to know and have NO idea that they should see someone after the milk comes in if they are still having or begin to have difficulty.  
On the other hand, I do see some progress as more pediatricians are breastfeeding themselves and learning firsthand what difficulties there can be and how to overcome them.  

-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Tina Lavy
Sent: Monday, June 14, 2010 12:35 PM
Subject: IBCLC funding

Hello fellow Lactnetters. I have been given the task to research opportunities for part-time or full time funding for a county health department non-RN IBCLC.  The job description would be similar to a PHN's duties of newborn nursery and mother/baby visits to assess breastfeeding, offer referrals and subsequent follow-up with WIC. 

At this point in time, the health department has PHN's who make rounds of the hospital and are paid out of county funds because it is an existing position. The "new" position would require "revenue generating funding" due to the current employment environment of lay-offs and cut backs.  Confincing administration that increasing our low breastfeeding rates would save dollars if you look at the bigger picture and can certainly be a part of the "sales promotion", but when you are working with a bottom line of being in the fiscal red or black at the end of the year,  it is a hard sell. Of course the traditional method of a grant is an option, but there is a need for sustainability. 

Is there a method of billing that could be utilized through Medicaid/Medical that would cover the hospital visit/assessment if the IBCLC is contracted through the local health department, but makes rounds at the delivering hospital?  What mechanisms of billing can be persued?  Any suggestions or ideas?

Thank you.

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