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AN ACT relating to Medicaid coverage for lactation support services and 1
breastfeeding equipment. 2
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 3
SECTION 1. A NEW SECTION OF KRS CHAPTER 205 IS CREATED TO 4
READ AS FOLLOWS: 5
(1) As used in this section: 6
(a) "Breast pump kit" means a collection of tubing, valves, flanges, bottles, and 7
other parts required to extract human milk using a breast pump; 8
(b) "Lactation consultation" means the provision of lactation care and services 9
by a qualified lactation support professional, including: 10
1. Lactation assessment; 11
2. Creation of a lactation care plan; 12
3. Lactation education; and 13
4. Recommendations for and instruction in the use of assistive devices; 14
(c) "Lactation counseling" means the provision of breastfeeding education and 15
support services by a qualified lactation support professional or other 16
licensed health care provider, including: 17
1. Providing a lactation assessment; 18
2. Creating a lactation care plan; 19
3. Providing lactation education, including educating women and 20
families on the health impacts of breastfeeding and human lactation; 21
4. Advocating for breastfeeding as the norm for feeding infants and 22
young children; 23
5. Providing breastfeeding support, encouragement, and care to help 24
women and families meet their breastfeeding goals; and 25
6. Identifying and, when appropriate, referring high-risk mothers for 26
clinical treatment; and 27 UNOFFICIAL COPY 23 RS BR 150
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(d) "Qualified lactation support professional" means an individual who holds a 1
current certification from a certification program accredited by the: 2
1. National Commission for Certifying Agencies; 3
2. Institute for Credentialing Excellence; or 4
3. American National Standards Institute. 5
(2) The Department for Medicaid Services and any managed care organization with 6
which the department contracts for the delivery of Medicaid services shall provide 7
coverage for comprehensive lactation counseling, lactation consultation, and 8
breastfeeding equipment. 9
(3) The coverage required by this section shall: 10
(a) Not be subject to: 11
1. Any cost-sharing requirements, including but not limited to 12
copayments; or 13
2. Utilization management requirements, including but not limited to 14
prior authorization, prescription, or referral, except as permitted in 15
paragraph (d) of this subsection; 16
(b) Be provided in conjunction with each birth for the duration of 17
breastfeeding, as defined by the beneficiary; 18
(c) For lactation counseling and lactation consultation, include: 19
1. In-person, one-on-one counseling or consultation, including home 20
visits, regardless of location of service provision; 21
2. The delivery of counseling or consultation via telehealth, as defined in 22
KRS 205.510, if the beneficiary requests telehealth counseling or 23
consultation in lieu of in-person, one-on-one counseling or 24
consultation; or 25
3. Group counseling, if the beneficiary requests group counseling in lieu 26
of in-person, one-on-one counseling or consultation; and 27 UNOFFICIAL COPY 23 RS BR 150
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(d) For breastfeeding equipment, include: 1
1. Purchase of a single-user, double electric breast pump, or a manual 2
pump in lieu of a double electric breast pump, if requested by the 3
beneficiary; 4
2. Rental of a multi-user breast pump on the recommendation of a 5
licensed health care provider; and 6
3. Two (2) breast pump kits as well as appropriately sized breast pump 7
flanges and other lactation accessories recommended by a health care 8
provider. 9
(4) (a) The breastfeeding equipment described in subsection (3)(d) of this section 10
shall be furnished within forty-eight (48) hours of notification of need, if 11
requested after the birth of the child, or by the later of two (2) weeks before 12
the beneficiary's expected due date or seventy-two (72) hours after 13
notification of need, if requested prior to the birth of the child. 14
(b) If the department cannot ensure delivery of breastfeeding equipment in 15
accordance with paragraph (a) of this subsection, an individual may 16
purchase equipment and the department or a managed care organization 17
with whom the department contracts for the delivery of Medicaid services 18
shall reimburse the individual for all out-of-pocket expenses incurred by the 19
individual, including any balance billing amounts. 20
Section 2. If the Cabinet for Health and Family Services or the Department for 21
Medicaid Services determines that a state plan amendment, waiver, or any other form of 22
approval or authorization from a federal agency is necessary prior to the implementation 23
of Section 1 of this Act, the cabinet or department shall, within 90 days after the effective 24
date of this Act, request the state plan amendment, waiver, approval, or authorization and 25
shall only delay full implementation of those provisions for which a state plan 26
amendment, waiver, approval, or authorization was deemed necessary until the state plan 27 UNOFFICIAL COPY 23 RS BR 150
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amendment, waiver, approval, or authorization is granted. The cabinet shall, in 1
accordance with KRS 205.525, provide a copy of any state plan amendment, waiver, or 2
other approval or authorization submitted pursuant to this section to the Interim Joint 3
Committee on Health, Welfare, and Family Services and the Interim Joint Committee on 4
Appropriations and Revenue and shall provide an update on the status of any application 5
submitted pursuant to this section upon request. 6
Section 3. In the event that the Legislative Research Commission dissolves the 7
Interim Joint Committee on Health, Welfare, and Family Services and establishes another 8
interim joint committee or committees with jurisdiction over health services or families 9
and children, the reports required by Section 2 of this Act and KRS 205.525 shall be 10
submitted to that committee or committees. 11