The new mother is asking for help and you know you could be of assistance. When she asks about insurance and payment, you tell her that lactation support, as a women’s preventative health service, is required to be provided under the Affordable Care Act. Nonetheless, you suggest she confirm with what is provided by their insurance plan.
Right there, that’s a delay to getting help when the family needs it. If they get a quick, and affirmative, response, that’s good. Oftentimes, they’ll be told there are no services provided. The family may not counter that and instead, forego getting the help they need. Families have also been given varying answers which causes confusion. Sometimes the answer they were given ultimately is not accepted once they submit a claim. These blunders are played out with annoying frequency.
All of these scenes represent obstacles to care. It is a failure to meet the obligation, under the Affordable Care Act, to provide lactation services. Despite their fatigue and frustration, families need to challenge this.
Currently, a class lawsuit is being formed in opposition to United Healthcare’s failure to provide for lactation consults. In 2018, a class action suit was brought against CareFirst. It was determined that CareFirst had failed to provide required services for breastfeeding women and their babies. The families were given a monetary award. Insurance companies, we hope, took notice.
Please let families know about this. This is specifically for families who are having difficulty with United Healthcare.
• They are current subscribers to United Healthcare.
• They have seen a lactation care provider and have not been reimbursed or had the services paid for by United Healthcare.
They can join this lawsuit by contacting:
KIMBERLY M. DONALDSON-SMITH Partner
Chimicles Schwartz Kriner & Donaldson-Smith LLP
One Haverford Centre
361 West Lancaster Avenue
Haverford, PA 19041
Office: 610-642-8500 x 302 Fax: 610-649-3633 Cell: 610-304-3067 Email: firstname.lastname@example.org
Parents are always encouraged to document their correspondence and phone calls with insurance companies. This can help to dispel confusion. It is also important information when one registers a complaint.
As practicing IBCLCs, we see many obstacles to support:
• lack of services • lack of payment for services • lack of knowledge of what support is needed. These class action suits are one step to improve lactation care and to assure support is accessible to all families.