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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