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In late December, durable medical equipment providers received a letter from Anthem informing them of a reduction in reimbursement for E0603, from $169.15 to $95.00.  The effective date is April 1, 2018.

CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, IL, NY, OH, VA, WI, are the states being affected.

Let’s work together to protect the families we work with to get the care and breastfeeding equipment they need!

You can use the following on social media:

Big changes are coming for thousands of moms with Anthem Blue Cross benefits.  @AnthemInc has decided to cut their rates for breastfeeding support starting April 1.  Many moms depend on quality breast pumps to care for their babies.  They are planning to reduce breast pump coverage to $95. At that low of a rate, there is no quality pump in existence that can extract milk or keep up your supply.   

Let @AnthemInc know that moms and babies matter.  Share your voice online and contact https://twitter.com/hashtag/antheminc to stress your concern.  Or send a letter: To the Chief Medical Officer, Craig Samitt, MD. (Craig.Samitt@anthem.com).

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Dr. Jenny Thomas has shared this information on Facebook and has given permission for us to share her post here. Please see her facebook page for the original post which you can share.

February 3, 2018

I use this site to share evidence-based science and practices and other really cool things about human milk but today I’m going to take a very personal and American turn and talk about the behavior of Anthem, Inc. The good news, by the end of this post, is that outcry from the public has reversed what I’m about to share in at least one state. I am hoping you will help.

On April 1st, 2018, Anthem BC/BS (my insurance company, and that of many in Southeastern Wisconsin) will cut breastfeeding support for the purchase of breast pumps for its customers by 45%, from $169.15 to $95. As many of you know, the breastfeeding provisions contained within the Affordable Care Act allowed for mothers to receive a breast pump at no cost sharing.

Anthem’s decision was announced to durable medical equipment (DME) suppliers for Anthem and not to Anthem subscribers who will only notice the change after April 1, 2018.

The decision is detrimental to the health of mothers and babies. If a mother uses an inferior pump, it affects her supply and ultimately her ability to meet her own and nationally set goals. I am especially motivated because it affects the mothers and babies for whom I care in Wisconsin, but this cut will also touch mothers in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, Illinois, New York, Ohio and Virginia.

I have already contacted Anthem and received this as a response from Kathryn Norman, Vice President, Provider Solutions at Anthem:

“Please be assured we are in complete agreement regarding the clinical value of breast milk for babies and we join you in wanting to see more mothers and babies engage in this practice for the reasons you stated.

The decision to reduce reimbursement for HCPCS E0603 followed extensive analysis and review of market dynamics. Quality, accessibility and affordability were important components in making this decision to ensure Anthem’s members will continue to receive high quality, affordable care. With that in mind and high confidence that quality affordable care remains intact, we respectfully decline the request that Anthem reverse the fee schedule reduction.” (End quote)

I am not aware of what data Anthem is using to support their decision other than the “review of market dynamics.” However, several different actuarial analyses conducted in 2017 and work done by health economists reached the predictable conclusion that supporting breastfeeding saves money. So if this decision moves forward as planned, and Anthem limits access to the quality breast pumps necessary in the US for the many, many women who need to return to work after their babies are born, Anthem will see higher costs in the short and long-term. This cut does not benefit them either.

If you are interested in helping to stop this cut, tag @AnthemInc on social media and/or email Chief Medical Officer Craig.Samitt@anthem.com. We know that public action by motivated, passionate people, changed the decision in Alabama. We have an opportunity to reverse this decision before it is implemented. Share this, post online, email. Let’s reverse this cut.

Thank you

Dr. Jen
(Jennifer Thomas, MD, MPH, IBCLC, FAAP, FABM)