Amendment 11 - Withdrawn

Amendment ID: S2899-11

Amendment 11

Lactation Care

Ms. Moran and Ms. Edwards move that the proposed new text be amended by adding the following sections:-

SECTION X. Section 11A of chapter 13 of the General Laws, as appearing in the 2020 Official Edition, is hereby amended by striking out the first paragraph and inserting in place thereof the following paragraph:-

There shall be a board of allied health professions, hereinafter called the board, which shall consist of 12 members to be appointed by the governor. Members of the board shall be residents of the commonwealth and citizens of the United States. Three of such members shall be athletic trainers licensed in accordance with section 23B of chapter 112; 2 of such members shall be occupational therapists licensed in accordance with said section 23B; 1 such member shall be an occupational therapy assistant licensed in accordance with said section 23B; 2 of such members shall be physical therapists licensed in accordance with said section 23B; 1 such member shall be a physical therapist assistant licensed in accordance with said section 23B; 1 such member shall be a lactation care provider licensed in accordance with said section 23B; 1 such member shall be a physician licensed in accordance with section 2 of chapter 112; and 1 such member shall be selected from and shall represent the general public.

SECTION X. Section 23A of chapter 112 of the General Laws, as so appearing, is hereby amended by inserting after the definition of “Board” the following definitions:-

“Breastfeeding equipment” means manual, electric, single user and multi-user breast pumps, breast pump flanges, nipple shields, and other lactation accessories recommended by a licensed lactation care provider or other health professional, whether a rental or a purchase.

“Lactation care and services”, the clinical application of scientific principles and a multidisciplinary body of evidence for the evaluation, problem identification, treatment, education and consultation to provide lactation care and services to families; provided, however, that lactation care and services includes, but is not limited to, lactation assessment through the systematic collection of subjective and objective data, analysis of data and creation of a plan of care; development and implementation of a lactation care plan with demonstration and instruction to parents and communication to the primary health care provider, provision of lactation education to parents and health care providers, and recommendation and use of assistive devices.

“Lactation care provider”, a person who provides lactation care and services.

“Licensed lactation care provider”, a person who is duly licensed to practice lactation care and services in accordance with section 23B.

“Nationally recognized accrediting agency” shall mean the National Commission for Certifying Agencies (“NCCA”), the Institute for Credentialing Excellence (“ICE”), and American National Standards Institute (“ANSI”).

SECTION X. Section 23B of said chapter 112, as so appearing, is hereby amended by inserting after the first paragraph the following paragraph:-

The Board may issue licenses for lactation care providers, without examination, to individuals who have furnished satisfactory proof that they are of good moral character and that they have met the requirements of section 23J½ upon completion of an application on a form furnished by the board and payment of a fee determined by the secretary of administration and finance.

SECTION X. Section 23D of said chapter 112, as so appearing, is hereby amended by inserting, in line 3, after the words “physical therapist assistant”, the following words:- “, or lactation care provider”

SECTION X. Said chapter 112 is hereby amended by inserting after section 23J the following section:-

Section 23J1/2. Lactation Care Provider

Section 23J½. An applicant for licensure as a lactation care provider shall possess current certification from a certification program accredited by a Nationally Recognized Accrediting Agency.

SECTION X. Section 23K of said chapter 112, as so appearing, is hereby amended by inserting in subsection (c), after the words “physical therapy”, the following words:- “, or lactation care and services”

SECTION X. Section 23L of said chapter 112, as so appearing, is hereby amended by inserting in subsection (c), after the words “physical therapist assistant”, the following words:- “, or lactation care provider”

SECTION X. Said chapter 112 is hereby amended by inserting after section 23P the following section:-

Section 23P¾. Lactation care providers, necessity for licensure

Section 23P¾. (a) No person shall hold themselves out to others as a licensed lactation care provider unless they hold a valid license issued in accordance with this chapter.

(b) Nothing shall be construed to affect or prevent the practice of lactation care and services by licensed care providers or other persons; provided that a person who is not a licensee shall not hold that person out or represent that person's self to be a licensed lactation care provider.

SECTION X. Chapter 175 of the General Laws, as so appearing, is hereby amended by inserting as Section 47CC the following:-

Section 47CC. (a) Any blanket or general policy of insurance described in subdivision (A), (C), or (D) of section 110 which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, during the period this provision is effective, or any policy of accident and sickness insurance as described in section 108 which provides hospital expense and surgical expense insurance and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth during the period that this provision is effective shall provide, to the same extent that benefits are provided for other pregnancy-related procedures coverage for lactation support consisting of, at minimum, lactation care and services by licensed lactation care providers provided that such services are within the lawful scope of practice for such providers, the costs of breastfeeding equipment, and the performance of any necessary maternal and newborn clinical assessments.

(b) An insurer providing coverage under this paragraph and any participating entity through which the insurer offers health services shall not:

(1) deny to a covered person eligibility, or continued eligibility, to enroll or to renew coverage under the terms of the policy or vary the terms of the policy for the purpose or with the effect of avoiding compliance with this paragraph;(2) provide incentives (monetary or otherwise) to encourage a covered person to accept less than the minimum protections available under this paragraph;(3) penalize in any way or reduce or limit the compensation of a health care practitioner for recommending or providing care to a covered person in accordance with this paragraph;(4) provide incentives (monetary or otherwise) to a health care practitioner relating to the services provided pursuant to this paragraph intended to induce or have the effect of inducing such practitioner to provide care to a covered person in a manner inconsistent with this paragraph; (5) restrict coverage for any portion of a period within a hospital length of stay required under this paragraph in a manner which is inconsistent with the coverage provided for any preceding portion of such stay; (6) require prior authorization, prescription or referral for lactation care and services; or(7) impose a deductible, coinsurance, co-payment or any other cost-sharing requirement for lactation care and services or breastfeeding equipment provided under this paragraph.

SECTION X. Chapter 118E of the General Laws, as so appearing, is hereby amended by adding after section 10N, the following section:

Section 10O: Medicaid Coverage for Lactation Care and Services.

(a) For purposes of this section, the following words shall have the following meanings:

“Division”, the division of medical assistance within the executive office of health and human services.

“Licensed lactation care provider”, a person who is duly licensed to practice lactation care and services in accordance with section 23B of Chapter 112.

(b) The division and its contracted health insurers, health plans, health maintenance organizations, behavioral health management firms and third-party administrators under contract to a Medicaid managed care organization or primary care clinician plan shall provide, to the extent that benefits are provided for other pregnancy-related procedures, coverage for lactation support consisting of, at minimum, lactation care and services by licensed lactation care providers provided that such services are within the lawful scope of practice for such providers, the cost of breastfeeding equipment, and the performance of any maternal and newborn clinical assessments, without any prior authorization, prescription or referral.

SECTION X. This act shall take effect 90 days after the date on which it shall have become a law.