Recently, USLCA’s President, Debi Ferrarello, MSN, MS, RN, IBCLC, RLC spoke with an attorney from the firm planning to launch a class action law suit on behalf of women who have been denied coverage for lactation counseling under the Affordable Care Act (ACA). Debi reports that the attorney was well aware that IBCLCs are the optimal providers of these services. The attorney had researched the number of IBCLCs in the United States and made the case that women who are denied coverage may turn to formula because they don’t get the help they need from qualified individuals. The attorney also mentioned the impact of this disruption in covered services on the business of the IBCLC. The attorney acknowledged that many insurance companies refer mothers to physicians or nurses who are not qualified to provide lactation consultation, or deny claims to out-of-network providers when they, in fact, have no in-network providers.
When asked why her firm was pursuing this lawsuit, the attorney explained to Debi that they are a class action lawsuit practice that has been focusing on the ACA for several years. The attorney cited the Women’s Law Project work, highlighting the fact that insurance companies are non-compliant with multiple facets of the ACA. Debi referred her to the National Breastfeeding Center’s Model Policy for Insurance Companies.
The Board of USLCA wants you to know about this upcoming case because as IBCLCs, we know that all families deserve access to the care of an IBCLC and that the ACA gives them the right to access our expert services. We know that as IBCLCs, most of us are connected with the families who might choose to opt-in to this class action suit. We recognize the difficulty that IBCLCs face when seeking reimbursement from insurance companies and that it significantly impacts their business model and, in some cases, creates a situation in which they can no longer remain in practice. This is an important step in realizing our vision of a nation in which all families have access to IBCLC care as a foundation of optimal health and wellness.