H.F. 2500 Section 1. MEDICAID REIMBURSEMENT FOR BREAST PUMPS. Under 1 both fee-for-service and managed care administration of 2 Medicaid, the department of human services shall adopt rules 3 pursuant to chapter 17A, amend any contract with a managed care 4 organization, and apply for any Medicaid state plan amendment 5 or waiver as may be necessary to provide reimbursement for 6 breast pumps, including electric breast pumps and associated 7 breast pump supplies, as prescribed by a Medicaid member’s 8 health care provider based on a determination of medical 9 necessity for the mother or child. The rules adopted by the 10 department shall include the specifications that a breast pump 11 must meet to be covered and the reimbursement rate applicable 12 to the specific type of breast pump and associated breast pump 13 supplies. 14 EXPLANATION 15 The inclusion of this explanation does not constitute agreement with 16 the explanation’s substance by the members of the general assembly. 17 This bill directs the department of human services (DHS) 18 under both fee-for-service and managed care administration of 19 Medicaid to adopt administrative rules, amend any contract 20 with a managed care organization, and apply for any Medicaid 21 state plan amendment or waiver as may be necessary to provide 22 reimbursement for breast pumps, including electric breast 23 pumps and associated breast pump supplies, as prescribed by a 24 Medicaid member’s health care provider based on a determination 25 of medical necessity for the mother or child. The rules 26 adopted by the DHS shall include the specifications that a 27 covered breast pump must meet and the reimbursement rate 28 applicable to the specific type of breast pump and associated 29 breast pump supplies. 30 -1- LSB 5980HV (2) 88 pf/rh 1/ 1