H.F. 2215 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. The rules adopted by the department shall include 10 the specifications that a breast pump must meet to be covered 11 and the reimbursement rate applicable to the specific type of 12 breast pump and associated breast pump supplies. 13 EXPLANATION 14 The inclusion of this explanation does not constitute agreement with 15 the explanation’s substance by the members of the general assembly. 16 This bill directs the department of human services (DHS) 17 under both fee-for-service and managed care administration of 18 Medicaid to adopt administrative rules, amend any contract 19 with a managed care organization, and apply for any Medicaid 20 state plan amendment or waiver as may be necessary to provide 21 reimbursement for breast pumps, including electric breast 22 pumps and associated breast pump supplies, as prescribed by a 23 Medicaid member’s health care provider based on a determination 24 of medical necessity. The rules adopted by the DHS shall 25 include the specifications that a covered breast pump must meet 26 and the reimbursement rate applicable to the specific type of 27 breast pump and associated breast pump supplies. 28 -1- LSB 5980YH (7) 88 pf/rh 1/ 1