Anthem BCBS Cuts Coverage for Breast Pumps by 45%

Breast Pump Cleaning Guidelines

On April 1st, 2018, Anthem Blue Cross Blue Shield cut breastfeeding support for the purchase of breast pumps for its customers by 45%, from $169.15 to $95. The breastfeeding provisions contained within the Affordable Care Act allowed for mothers to receive a breast pump at no cost-sharing.

This article from the Virginian-Pilot website delves further into the issue:

“Anthem spokesman Scott Golden said in an email the decision ‘will not impact the ability of any new mother to access a high-quality, standard double electric breast pump from our nationally contracted medical suppliers.’ Company officials declined to be interviewed.”

“But breastfeeding advocates and medical professionals worry the change could lead women to give up breastfeeding in a society that can already make it a difficult practice to sustain, especially if their electric pumps’ motors break down or if better pumps must be bought out of pocket.”

Dr. Jen Thomas, pediatrician and IBCLC, shared her thoughts on the issue in a Facebook post on her page:

“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.

“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.”

Please continue to share this important information and to tag @AnthemInc on social media or on Twitter speak up to @AnthemBCBS_news using the hashtag #Anthemstopthecut. Or check out this post on Dr. Jen’s page for a sample letter to send to Anthem. You can also sign this petition to urge Anthem to change their policy.


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