Breastfeeding and Obamacare - Mothering Forums

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#1 of 74 Old 08-05-2013, 09:50 AM - Thread Starter
 
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The Affordable Care Act (aka: Obamacare) mandates that "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum, provide coverage for and shall not impose any cost sharing requirements for evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force"

 

Breastfeeding qualifies under the above guidelines. The Secretary of the Department of Health and Human Services has been assigned the task of how to "promote and support" breastfeeding under the Affordable Care Act. Thus far there has been a lot of talk and very little action as far as how to get this done. In spite of the fact that this is THE BEST opportunity to increase breastfeeding rates in the U.S., insurance companies, doctors, hospitals, and the general public are all still wondering what health insurance policies will cover with respect to "promoting and supporting" breastfeeding.

 

When did breastfeeding become so complicated? There is very little that we do not already know about breastfeeding... the benefits, the challenges, the methods for overcoming those challenges... and yet the federal government has been unable to provide the guidance which is necessary for everyone to know the answers to the who (ie. who is covered and who will provide services), what (ie. what services and what breastfeeding items will be covered), where (ie. doctors' offices, hospitals, prenatal classes), and when (ie. at what point during pregnancy and postnatal) questions.

 

Do you have any suggestions as to how the Affordable Care Act should "promote and support" breastfeeding? Please post your suggestions in this thread. Also, please contact your U.S. senator and congressperson to let them know what your suggestions are. After all, there is no better source of advice than those of us who have been there and done that.

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#2 of 74 Old 08-05-2013, 10:29 AM
 
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Mandatory paid maternity leave for at least 10 weeks
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#3 of 74 Old 08-11-2013, 07:57 AM
 
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As for things health care markets can do, I think covering breastfeeding education classes is a start. They should be certified to somehow not allow for formula centric rhetoric though.
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#4 of 74 Old 08-11-2013, 12:04 PM
 
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Free support phone line for those who do not have such services readily available.

 

As far as the super tangible: Cover breast pumps.

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#5 of 74 Old 08-12-2013, 08:12 AM - Thread Starter
 
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As far as covering breast pumps... yes, yes, yes. However, the details on how to best accomplish that have not yet been determined. Some insurance companies have provided inappropriate and/or cheap breast pumps which cause mothers to give up on breastfeeding. That is why insurance companies should provide breast pumps based on a prescription written by a health care professional such as a doctor or certified lactation consultant.

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#6 of 74 Old 08-12-2013, 11:34 AM
 
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freee lactation consultant visit at home 2 days after d/c from hospital

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#7 of 74 Old 08-12-2013, 12:39 PM
 
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The number one thing is to take away the stigma of BFing, both in private and public.  Women are under such pressure from uninformed family members and close friends and husbands/significant others, but also in society.  I don't see many on the subway outside of myself who feeds my baby as needed.  Since he is 11 months old now (but looks 14 months), the forgiving looks are dwindling into judgmental ones.  That's not going to stop me from feeding him discreetly, but I can imagine it being difficult for many women.

 

I will say NYC had been doing a good job of putting up BFing posters encouraging, urging, and giving great stats.  But those seem to have disappeared.  I think awareness campaigns like those should be as constant as Quit Smoking and Teen Pregnancy campaigns they consistently have up and about. 

 

The more women and families aware of the advantages, the more voices to join in asking for and receiving what we need from our healthcare systems.

 

Be well.

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#8 of 74 Old 08-13-2013, 06:36 AM - Thread Starter
 
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The WIC Program ran a tv advertising campaign promoting the benefits of breastfeeding. That campaign was quite successful, particularly among young, single women who are less likely to have family or friends that encourage breastfeeding. In spite of the success of that tv ad campaign, the funding was cut. Why? Because the breastfeeding lobbyists don't have the same level of clout in DC as those other guys. That is why it is so important that insurance companies be required to include breastfeeding awareness/counseling/training (whatever you want to call it) as part of the Affordable Care Act. After all, when nurses in hospitals are handing out free formula samples to new mothers, and doctors are doing the same thing in their offices, what message is that sending? That may be a brilliant marketing strategy by the formula companies, but health care professionals should be endorsing behavior that results in the healthiest outcome for their patients... which is breastfeeding. When health care professionals start receiving compensation from insurance companies for having a serious discussion with their patients about why breastfeeding is best, then the difference between the promotion of breastfeeding and formula will become a little more balanced.

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#9 of 74 Old 08-16-2013, 06:19 PM
 
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#10 of 74 Old 08-18-2013, 05:27 PM
 
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I live in China and had my baby here. Mothers get 6 months PAID maternity leave AND after they start working again are allowed to leave work very few hours to bf. they cannot be fired for at least a year after they return to work (In case an employer wanted to fire mother for leaving to nurse). If they are fired for any reason, companies pay a HUGE fine to the mother. Obama is always praising China policies....Obamacare could start here....
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#11 of 74 Old 08-18-2013, 05:29 PM
 
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And why is it always the benefits of breastfeeding? The slogans should be the dangers/risks of formula. And I'm not knocking mothers who have formula fed, just saying there are risks.
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#12 of 74 Old 08-18-2013, 07:10 PM
 
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Here's a suggestion... How about medical schools and nursing schools devote time out of their curriculum (when they do their pediatric/OB/GYN rotations) specifically to educate their students about breastfeeding so they can educate their patients once they get into practice? I personally think that all pediatricians should be certified lactation consultants. My kids' pediatrician is one.

 

BTW, some of you have mentioned free this, free that be covered under Obamacare. You do know that it's not free, right? Someone has to pay for all these benefits. So, please, don't call it free because it's not.


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#13 of 74 Old 08-19-2013, 10:23 AM - Thread Starter
 
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According to the study "Clinical Preventive Services for Women", published in 2011 by the National Academy of Sciences, on page 110, "A recent study concluded that if 90 percent of all children were exclusively breastfed during the first six months of life, the United States would save $13 billion per year and prevent an excess of 911 deaths."

 

I have not read the study referred to on page 110, so I don't know who specifically would "save $13 billion", but I would think the insurance companies would save enough money from the improved health of their customers (mothers and infants) so they could cover the cost of providing breastfeeding counseling, breast pumps, etc. In other words, yes, I do think these services are free. There could very well be other cost savings from breastfeeding that could not be measured... such as improved brain development resulting in lower costs to schools that have to provide specialized services to kids who enter school with learning disabilities.

 

I would also like to note that even though the "Clinical Preventive Services for Women" report does a good job of describing the issues that have prevented breastfeeding rates in the U.S. from increasing, the National Academy of Sciences missed out on a golden opportunity to provide their input as to what specific breastfeeding services should be provided by insurance companies, who should provide those services, at what stage in the pregnancy the breastfeeding counseling should be provided, what qualifications the people providing the counseling should have, where the services should be provided (doctors' offices, hospital, etc), who determines what kind of breast pump each woman should get, etc, etc. Instead, the recommendation by the National Academy is so vague that the U.S. Department of Health and Human Services (who asked for the study) have no information to help guide the rules they are supposed to come up with. That was the whole purpose of this thread to begin with. The federal government seems to be totally perplexed about how to "promote and support" breastfeeding as required by the Obamacare law. Look at healthfinder.gov. Look at healthcare.gov. Look at the U.S. Surgeon General's website. All of them say breastfeeding rates are too low so we need to do more to encourage women to breastfeed, but none of those websites offer suggestions on how to do that. That's why WE need to contact our senators and congresspeople to let them know what services and material items should be provided by insurance companies. 

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#14 of 74 Old 08-19-2013, 11:19 AM
 
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According to the study "Clinical Preventive Services for Women", published in 2011 by the National Academy of Sciences, on page 110, "A recent study concluded that if 90 percent of all children were exclusively breastfed during the first six months of life, the United States would save $13 billion per year and prevent an excess of 911 deaths."

 

I have not read the study referred to on page 110, so I don't know who specifically would "save $13 billion", but I would think the insurance companies would save enough money from the improved health of their customers (mothers and infants) so they could cover the cost of providing breastfeeding counseling, breast pumps, etc. In other words, yes, I do think these services are free. There could very well be other cost savings from breastfeeding that could not be measured... such as improved brain development resulting in lower costs to schools that have to provide specialized services to kids who enter school with learning disabilities.

 

The insurance companies do not care about the health and well-being of their customers. They don't make money from healthy people. This is why I feel that they are not the ones to be promoting breastfeeding. That should be coming from a woman's doctor or midwife and her child's pediatrician. Also, LLL and whatever other pro-breastfeeding organizations that are out there... private or volunteer based. Oh, and the "free" angle, please explain how all these new benefits are free? Are the companies who make breast pumps going to donate their products without passing along the cost of making them to the consumer?

 

I would also like to note that even though the "Clinical Preventive Services for Women" report does a good job of describing the issues that have prevented breastfeeding rates in the U.S. from increasing, the National Academy of Sciences missed out on a golden opportunity to provide their input as to what specific breastfeeding services should be provided by insurance companies, who should provide those services, at what stage in the pregnancy the breastfeeding counseling should be provided, what qualifications the people providing the counseling should have, where the services should be provided (doctors' offices, hospital, etc), who determines what kind of breast pump each woman should get, etc, etc. Instead, the recommendation by the National Academy is so vague that the U.S. Department of Health and Human Services (who asked for the study) have no information to help guide the rules they are supposed to come up with. That was the whole purpose of this thread to begin with. The federal government seems to be totally perplexed about how to "promote and support" breastfeeding as required by the Obamacare law. Look at healthfinder.gov. Look at healthcare.gov. Look at the U.S. Surgeon General's website. All of them say breastfeeding rates are too low so we need to do more to encourage women to breastfeed, but none of those websites offer suggestions on how to do that. That's why WE need to contact our senators and congresspeople to let them know what services and material items should be provided by insurance companies. 

 

As you can see, the federal government is not good at this. Why would you want them to be involved? They should not be involved with one's personal decision about how they will feed their infant. Again, a woman's doctor, midwife, personal care practitioner is the one to promote breastfeeding with their patients. It all starts there.


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#15 of 74 Old 08-19-2013, 12:39 PM - Thread Starter
 
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Insurance companies do care about the health of the people they insure. They lose money when their customers get sick and file insurance claims.

 

There is documented evidence that, in children, breastfeeding reduces...

- gastrointestinal infections

- upper and lower respiratory diseases

- childhood leukemia

- asthma

- ear infections

- childhood obesity

- diabetes

Also, breastfeeding results in lower rates of breast and ovarian cancers in women.

 

Less illness equals fewer insurance claims which results in less money being paid out by insurance companies. The savings from fewer insurance claims could be used to offset the cost of providing breastfeeding counseling and breast pumps. The insurance companies probably won't be the people encouraging mothers to breastfeed (although if they were smart they would do so). The people who will counsel mothers to breastfeed will be the health care providers... probably as part of a wellness checkup. The additional time it takes a health care provider to talk with a patient about breastfeeding will be billed to the insurance company. Again, that addition cost will be offset by the savings resulting from fewer cases of gastrointestinal infections, respiratory diseases, leukemia, asthma, etc.

 

The government won't be involved in deciding whether or not a woman should breastfeed. The government has finally recognized that if more infants are breastfed, we will have a healthier society. The government has also finally recognized that breastfeeding has a tough time competing with the marketing efforts of the formula companies. Health care professionals have been reluctant to spend a lot of time talking with their patients about breastfeeding because they haven't been compensated for doing that. If the U.S. Secretary of Health and Human Services puts together a set of rules about what insurance companies will pay for with respect to improving the communication about breastfeeding between women and their health care providers, then the result should be higher breastfeeding rates and a healthier population. 

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#16 of 74 Old 08-19-2013, 02:55 PM
 
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Insurance companies do care about the health of the people they insure. They lose money when their customers get sick and file insurance claims.

 

I really, honestly, don't mean to be rude or argumentative, but health insurance companies do not care about people, they care about profits. They stand to make billions from Obamacare being implemented. They had a hand in it getting passed. They will have roughly 30 million more customers come next year. Healthy people may not be filing claims as much as the sick, but they are being forced to pay monthly premiums for something they may not use much. It's guaranteed income and profit for those companies... thanks to Obamacare.

 

There is documented evidence that, in children, breastfeeding reduces...

- gastrointestinal infections

- upper and lower respiratory diseases

- childhood leukemia

- asthma

- ear infections

- childhood obesity

- diabetes

Also, breastfeeding results in lower rates of breast and ovarian cancers in women.

 

Not necessary to mention this for my benefit. I am fully aware of above, and don't dispute these facts about breastfeeding. I nursed both my kids.

 

Less illness equals fewer insurance claims which results in less money being paid out by insurance companies. The savings from fewer insurance claims could be used to offset the cost of providing breastfeeding counseling and breast pumps.

 

How long do you think it will take to get to that point? What happens in the meantime?

 

The insurance companies probably won't be the people encouraging mothers to breastfeed (although if they were smart they would do so).

 

You're right. They wouldn't do that, and leave that stuff up to the healthcare providers.

 

The people who will counsel mothers to breastfeed will be the health care providers... probably as part of a wellness checkup.

 

Yes, as it should be.

 

The additional time it takes a health care provider to talk with a patient about breastfeeding will be billed to the insurance company. Again, that addition cost will be offset by the savings resulting from fewer cases of gastrointestinal infections, respiratory diseases, leukemia, asthma, etc.

 

Charge extra for breastfeeding counseling? In addition to prenatal care?

 

The government won't be involved in deciding whether or not a woman should breastfeed. The government has finally recognized that if more infants are breastfed, we will have a healthier society. The government has also finally recognized that breastfeeding has a tough time competing with the marketing efforts of the formula companies.

 

The role of the federal government should not be used for this.

 

Health care professionals have been reluctant to spend a lot of time talking with their patients about breastfeeding because they haven't been compensated for doing that.

 

So, what you are saying is, a doctor won't discuss breastfeeding because they aren't getting paid extra to do so? That is a really ridiculous statement. Where is the proof of this? If you've encountered this personally, you should run far, far away from that person.

 

If the U.S. Secretary of Health and Human Services puts together a set of rules about what insurance companies will pay for with respect to improving the communication about breastfeeding between women and their health care providers, then the result should be higher breastfeeding rates and a healthier population. 

 

That's not a good use of taxpayer dollars. No more rules. Rules for improving communication between a patient and their doctor? Way too intrusive. Keep the government out of the exam room, please. Breastfeeding counseling should be part of the prenatal package. Are there ICD-9 and CPT codes for breastfeeding counseling in the works?

 


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#17 of 74 Old 08-20-2013, 06:37 AM
 
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Having insurance companies provide breast pumps is great, but the process right now is terrible. You should be able to get the pump your OB/midwife or LC recommends, you should be able to buy it from wherever you want and get refunded and you should not have to wait until after you give birth to get it. I get that they want to only provide them for people who actually give birth, but seriously, wait until 20 weeks or so and that won't be much of an issue. I pumped with my first DD, so I knew how to use the pump and get it put together, but for new moms they shouldn't be having to figure that out with a newborn.

Provide free breastfeeding classes (there are a lot of these already honestly, but I'm sure there are gaps to be filled), free phone/online support/Q&A, and at least a certain number of covered LC visits. And maybe a free book or pamphlet or two on BFing as well if desired.

Allowing healthcare providers to bill for BFing counseling/advice so the time they do that is paid for so they don't feel like they are just squeezing it into a normal appointment.

I will say the LC presence in the hospital for my twins in 4/2013 was much better than when I had my DD in 11/2009, so that has improved a lot. I had a LC stopping by once in the morning and once in the afternoon every day I was there this time, last time I had to ask for a LC and she can just before I left which wasn't ideal. No idea if the government helped with that or if that is just hospitals working to be more competitive.

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#18 of 74 Old 08-28-2013, 08:45 AM - Thread Starter
 
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In a perfect world there would be no need to "promote" breastfeeding because pregnant women would be encouraged to breastfeed by the father of the child and other family members. Unfortunately, there are far too many pregnant women who receive little or no family support at all to even consider breastfeeding. In those cases, the doctor would be the next logical person to talk with her/his patient about breastfeeding. I would think that most of the women reading this thread didn't need much convincing to start breastfeeding their baby... or to continue to breastfeed even when they experienced a problem. The time it takes to provide breastfeeding counseling, advice, coaching, guidance, and tender loving care to a new mother who has no knowledge of breastfeeding and very little family support to breastfeed, can be considerable. Doctors simply don't have the amount of time needed to personally assist all their patients with breastfeeding "support". However, if insurance companies are going to pay health care professionals to provide breastfeeding counseling, advice, coaching, guidance, and tender loving care as part of Obamacare, then doctors will be able to have trained lactation consultants in their practice to provide those services. The payment for those services will be in the form of an insurance claim which is the same way insurance companies pay for blood tests, xrays, etc. The insurance companies should benefit from this policy immediately because their customers (mothers and children) will be healthier, resulting in fewer claims for health issues that will be prevented by breastfeeding.

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#19 of 74 Old 08-28-2013, 11:23 AM
 
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another idea:

the dollars should be spent on something that has great evidence backing it,s efficacy.

 

WHO looked for that: what is most cost-effective intervention to help support and increase breastfeeding rate and duration?

WHO cam up with ''baby friendly initiative'' first for hospitals, then clinics, then public health services.

 

no need to reinvent the wheel. just investing money making sure that every single hospital where babies are born, has ''baby friendly'' designation.

it,s inexpensive, but it works! numerous studies proved it.

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#20 of 74 Old 09-19-2013, 06:47 AM - Thread Starter
 
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Last week I attended a fund raising event at a non-profit pregnancy resource center. In her speech, the executive director of the organization gave a couple of examples of how her organization is changing lives. They provide tutoring for women who didn't graduate from high school and are now interested in getting their GED. She also talked about the parenting classes they offer which help women to make better decisions. Their programs are truly life altering.

 

That got me to thinking about how the new rules in Obamacare relating to breastfeeding "promotion and support" could also change lives. For those mothers whose families have traditionally formula-fed, who don't have a close relationship with a doctor, and who are given formula in a cute little gift bag by health care workers at the hospital just before they leave with their newborn, there has not been the encouragement needed to break away from formula feeding. We finally have a method here in the U.S. to compete against the very effective marketing done by the formula manufacturers. If the U.S. Department of Health and Human Services (DHHS) will put in place a set of regulations for health care insurers that will help all women learn the truth about why breastfeeding is better than formula feeding, and will also require insurers to provide qualified people to help women when they encounter a problem while breastfeeding, then this also can be a life altering experience. You can help break the cycle of formula feeding by urging your Senators and Congresspeople to contact the DHHS and demand that they issue meaningful rules for breastfeeding "promotion and support" (as Congress intended) as part of the Affordable Care Act.  

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#21 of 74 Old 10-01-2013, 06:27 PM
 
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As a working Board Certified Lactation Consultant (even though I am in favor of about 95% of the Affordable Health Care Act) we, as IBCLCs have been having problems with the new rules in the AHCA ("Obamacare.") Some of the insurance companies assume that new mothers ONLY need Lactation Consultants while they are "in the hospital" and thus are only wanting to compensate what they are terming "Certified Nurse Specialists." Um, many Lactation Consultants are not "Certified Nurse Specialists" and most breastfeeding issues occur 5-25 days after the birth of the baby and NOT while mom and baby are "still in the hospital." This thinking also disregards that some women never give birth in a hospital, or leave within hours of giving birth, so seeing a "Certified Nurse Specialist" (who do NOT work as Private Practitioner) at all.

 

Also, IBCLCs are International Board Certified meaning we are NOT "state certified" or "licensed" at all. We are Internationally Certified (which means we can practice anywhere in the world or in any state in the USA without further certification) and are registered but, for some reasoned are not "licensed."

 

A few weeks ago we had a client who specified she needed a "Certified Nurse Specialist" because that is what her insurance company (knowing NOTHING about lactation) required in order to reimburse her) and when we told her that wasn't what we were, she started calling all the "Certified Nurse Specialists" in her area. ALL of them were hospital based, NONE were Private Practice (which meant that NONE of them would see patients in their homes) and NONE of them were "specialists" in Lactation. She got some surgical CNS, addiction CNS, respiratory care CNS but NONE of them were Lactation Consultants nor would see a patient who wasn't an inpatient in a hospital or in hospice. As a result she was told that she had to pay out of pocket, and we did recommend she see one of our LCs and then submit the SuperBill after the visit, knowing they might not pay her back.

 

We're terrified that more and more clients will run into this misunderstanding by insurance companies of WHAT IBCLCs are, what we do, and where we work (most of us do NOT work in hospitals, and the ones who do work in hospitals will not come to make a home visit making women with newborn babies have to go out of her own comfortable home for a short visit. (My visits, as a Private Practice IBCLC working for a labor and post partum doula-midwife-lactation agency, usually run 90 to 120 minutes and take place in the clients home. The average LC visit in a hospital run about 3-10 minutes.)

 

As for "free lactation care" I'm not sure how we can get insurance companies to pay for visits. We need to make a living, too, and so our agency charges at the time of service (through the agency I don't take any money, thank heavens. I did that as a home based Private Practice LC and it was not pleasant)  we fill out the Super Bill and then fax it to the client for her to submit to the insurance company. If there was an easier way to do this and still get paid for our services and not burden our clients unduly, I can't think of one.

 

The insurance companies and The Affordable Care Act need to understand 1) ONLY IBCLCs should be seeing lactation clients for lactation problems professionally, (no "lactation nurses" with no training and no "certified lactation educators." These people are only certified to teach breastfeeding classes. NOT to  examine mothers and infants or diagnose lactation issues, set up treatment plans or assist with feeding in any way. They have a weekend intensive for training, as IBCLCs we learn and train for THREE years, as a post graduate program after earning at least a Bachelor's Degree in a related field,  and then sit for 8 hour boards... every 5 to 10 years for the entire time we practice, as well as keep up CERPs for continuing education. The gap between "Certified Lactation Educators" and "Board Certified Lactation Consultants" is about as wide as the gap between someone who took a High School level First Aid Class and an MD with 4 years of Med School and years of residency plus sitting for their boards. (If I sound upset, I am. You can't bill yourself as anything that sound like a physician, if you aren't a physician, yet there several groups of minimally trained people who bill themselves as "Lactation Consultants" or "Lactation Specialists" and the law is dong NOTHING about these people misrepresenting themselves and mothers and babies are not being served and in many cases even hurt by these misunderstandings. Of course, this leaves La Leche League Leaders in Limbo as many of them are very well educated in lactation but many lack certification. But, as LL leaders do not and MAY Not charge for their services, it is a different thing.)

 

2)(yes, there is more) The AHCA and the insurance companies need to understand that many IBCLCs are not RNs and do not need to be. All IBCLCs are specialists in LACTATION only and need to sit for the same boards, get their CERPs, their classes, their Patient Contact Hours the same as any other IBCLC. (Not to mention there is a NEW "thing" called a "Advanced Lactation Consultant" that can be had without first becoming a Board Certified IBCLC! It's the Wild West out here in Lactation, ladies.)

 

3) IBCLCs do not all work in hospitals and most lactation issues happen after release from the hospital after the baby's birth AND some women do not even give birth in hospitals, but they need lactation services as well.

 

Sorry for the text wall. I had to speak my piece. This is my livelihood and this is my passion. :stillheart 


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#22 of 74 Old 10-02-2013, 11:46 AM
 
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I would suggest taking a look at the Netherlands and copying their model.  They are supportive in pregnancy, natural birth, maternity and paternity leave, and breastfeeding, as well as childcare and schooling.

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#23 of 74 Old 10-02-2013, 04:01 PM
 
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I would suggest taking a look at the Netherlands and copying their model.  They are supportive in pregnancy, natural birth, maternity and paternity leave, and breastfeeding, as well as childcare and schooling.

I wish the USA would! Sadly, so many are so afraid of "Socialism" that any hint of this type as wonderful type of care is shot down by too many before it even gets a change to be looked at in detail.

 

I'd be 100% behind such a system. :)

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#24 of 74 Old 10-03-2013, 01:22 PM
 
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I'd also be in favor of such a system (and I"m pretty much a  libertarian, too), though I do get wary at those who insist on mandatory paid maternity leave paid for completely by a business owner without considering this would be detrimental to many, many small businesses. 

 

As it stands, I understand that many countries that require paid maternity leave only require 50% of the paycheck.

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#25 of 74 Old 10-03-2013, 02:08 PM - Thread Starter
 
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MaggieLC - Great post! There is a very good reason why you are frustrated. To help explain that reason, here's a quote from a July 18, 2013 press release from the U.S. Breastfeeding Committee: the first sentence reads, "In the rapidly-changing landscape of insurance requirements rolling out under the Affordable Care Act, few have been more confusing than the requirement to cover "breastfeeding support, supplies, and counseling" (starting in the first plan year that began on or after August 1, 2012)."

 

Here are the guidelines for insurance companies that were issued by the U.S. Department of Health and Human Services: "Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment." That's it. There are no further instructions for insurance companies to follow. No standards. No definitions. No recommendations. Every time I read those "guidelines" I come up with another question or two... and  there's no method to get answers to my questions.

 

As far as I'm concerned, the "guidelines" issued by the DHHS are not guidelines at all. What they issued merely represents the goal that is trying to be accomplished. The instructions or rules that are needed in order to achieve that goal are totally missing. If you have any questions or complaints about your insurance coverage for breastfeeding support and services, please contact your Congressperson or Senator... they're the ones who created this mess!

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#26 of 74 Old 10-03-2013, 02:15 PM
 
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What you need is longer paid maternity leave. That is what undermines breastfeeding the most, I think--having to go back to work at 4 or 6 weeks or whatever. Most countries get something like 6 months, a year, ect.

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#27 of 74 Old 10-03-2013, 02:50 PM
 
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What you need is longer paid maternity leave. That is what undermines breastfeeding the most, I think--having to go back to work at 4 or 6 weeks or whatever. Most countries get something like 6 months, a year, ect.

 

I still don't think this can be addressed at all under the Healthcare mandate.  It concerns insurance companies and their policies.  What this would take is another law (laws!) entirely, mandating businesses to pay for the extended leave, providing the funds for small businesses that can't afford to pay for leave plus a replacement employee, or creating a fund employees pay into.

 

Not Obamacare's territory at all.

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#28 of 74 Old 10-03-2013, 03:40 PM
 
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MaggieLC - Great post! There is a very good reason why you are frustrated. To help explain that reason, here's a quote from a July 18, 2013 press release from the U.S. Breastfeeding Committee: the first sentence reads, "In the rapidly-changing landscape of insurance requirements rolling out under the Affordable Care Act, few have been more confusing than the requirement to cover "breastfeeding support, supplies, and counseling" (starting in the first plan year that began on or after August 1, 2012)."

 

Here are the guidelines for insurance companies that were issued by the U.S. Department of Health and Human Services: "Comprehensive lactation support and counseling, by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment." That's it. There are no further instructions for insurance companies to follow. No standards. No definitions. No recommendations. Every time I read those "guidelines" I come up with another question or two... and  there's no method to get answers to my questions.

 

As far as I'm concerned, the "guidelines" issued by the DHHS are not guidelines at all. What they issued merely represents the goal that is trying to be accomplished. The instructions or rules that are needed in order to achieve that goal are totally missing. If you have any questions or complaints about your insurance coverage for breastfeeding support and services, please contact your Congressperson or Senator... they're the ones who created this mess!

Thank you.

 

Yes, the "guidelines" are so vague that it allows insurance companies to interpret them as they want. Nothing about breastfeeding "supplies" that need to be bought rather than rented (nipple shields, SNSs, tubing, syringes, shells) or pumps that are for purchase only. "Trained provider" could be ANYTHING. They need to identity "Board Certified Lactation Consultant who has completed the paths and passed the Boards laid out by the International Board of Lactation Consultant Examiners." Nope, "trained professional" which leaves the door open for people who have taken a weekend intensive intended for teaching classes to evaluate and set up treatment plans that they are not trained or educated to do.

 

I don't do any billing. (Thank heavens, I work for an agency that does all that. When I had my own business I did, but that was several years ago. I'm glad to be part of an agency that does all the billing and insurance stuff for us.) Basically, we have to let the clients submit their own bills as we have been doing. It is frustrating for us and the clients.


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#29 of 74 Old 10-03-2013, 06:21 PM
 
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What if the insurance companies offered some incentives to the doctors who encourage breastfeeding and maintained high breastfeeding rates among moms with babies?  Doctors should also be required to get enough training to be lactation consultants. I really do think it would make a difference if people got this information from their personal doctors vs. having to seek out a LC or someone else.  It makes it seem less important, kwim?  If women are hearing that breast is best from people they know, but formula is just fine from their doctor, who are they going to trust?

 

Just imagine if DOCTORS put the same emphasis and effort on breastfeeding as they do for vaccines?  

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#30 of 74 Old 10-04-2013, 04:11 PM
 
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I would like to respectfully disagree with the whole idea of getting more laws about breastfeeding on the books.  Breasfeeding is important but it is best supported and encouraged locally, by family members and friends and random strangers smiling at other random strangers who breastfeed in public.  Getting a government agency involved is only going to add red tape to the process.  

 

The fact is, the la leche league is free.  As is internet access with the multitude of research and resources that are on here.  New moms don't need the government to tell them to do one more thing (in that cute formula bag are more papers than I've had to read since college).  New moms need their communities to reach out and help them see that breastfeeding is healthy AND normal.  Post a flyer for a la leche meeting on a library bulletin board.  Talk to other new moms about breastfeeding's benefits.  That will do more than paying a government worker to pay an insurance company to pay someone to keep track of what breastfeeding support options are so that the whole system can then pay for lactation consultants that many new moms don't want. 

 

Breastfeeding or lack thereof is a cultural issue and I think we need to attack it that way.  Formula is not normal!   Spread the word! :) :) :) :)

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