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US state policies for Medicaid coverage of donor human milk.

ABSTRACT: Donor human milk is recommended by the American Academy of Pediatrics for high-risk infants when mother's own milk is absent or insufficient in quantity. Several factors may contribute to the inequitable use of or access to donor human milk, including a limited knowledge of its effects, cost, reimbursement, and regulatory barriers. The American Academy of Pediatrics and the United States Surgeon General have called for investigating barriers that prevent use of donor human milk for high-risk infants and for changes to public policy known to improve availability and affordability. We review the current legislative, regulatory, and economic landscape surrounding donor human milk use in the United States, as well as suggest state- and federal-level solutions to increase access to donor human milk.

SUBMITTER: Rose AT

PROVIDER: S-EPMC8979482 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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US state policies for Medicaid coverage of donor human milk.

Rose Allison T AT Miller Emily R ER Butler Margaret M Eden Claire C Kim Jae H JH Shah Shetal I SI Patel Ravi M RM

Journal of perinatology : official journal of the California Perinatal Association 20220404 6

Donor human milk is recommended by the American Academy of Pediatrics for high-risk infants when mother's own milk is absent or insufficient in quantity. Several factors may contribute to the inequitable use of or access to donor human milk, including a limited knowledge of its effects, cost, reimbursement, and regulatory barriers. The American Academy of Pediatrics and the United States Surgeon General have called for investigating barriers that prevent use of donor human milk for high-risk inf ...[more]

PMID: 35379899

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Project description:ObjectiveTo systematically review Medicaid policies state-by-state for gender-affirming surgery coverage.Data sources and study settingPrimary data were collected for each US state utilizing the LexisNexis legal database, state legislature publications, and Medicaid manuals.Study designA cross-sectional study evaluating Medicaid coverage for numerous gender-affirming surgeries.Data collection/extraction methodsWe previously reported on state health policies that protect gender-affirming care under Medicaid coverage. Building upon our prior work, we systematically assessed the 27 states with protective policies to determine coverage for each type of gender-affirming surgery. We analyzed Medicaid coverage for gender-affirming surgeries in four domains: chest, genital, craniofacial and neck reconstruction, and miscellaneous procedures. Medicaid coverage for each type of surgery was categorized as explicitly covered, explicitly noncovered, or not described.Principal findingsAmong the 27 states with protective Medicaid policies, 17 states (63.0%) provided explicit coverage for at least one gender-affirming chest procedure and at least one gender-affirming genital procedure, while only eight states (29.6%) provided explicit coverage for at least one craniofacial and neck procedure (p = 0.04). Coverage for specific surgical procedures within these three anatomical domains varied. The most common explicitly covered procedures were breast reduction/mastectomy and hysterectomy (n = 17, 63.0%). The most common explicitly noncovered surgery was reversal surgery (n = 12, 44.4%). Several states did not describe the specific surgical procedures covered; thus, final coverage rates are indeterminate.ConclusionsIn 2022, 52.9% of states had health policies that protected gender-affirming care under Medicaid; however, coverage for various gender-affirming surgical procedures remains both variable and occasionally unspecified. When specified, craniofacial and neck reconstruction is the least covered anatomical area compared with chest and genital reconstruction.

Dataset Information

US state policies for Medicaid coverage of donor human milk.

Publications

US state policies for Medicaid coverage of donor human milk.

Similar Datasets

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