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Advocating for Pasteurized Donor Human Milk

The Journey for Medicaid Reimbursement in New York State

Schmaltz, Christopher H. DNP, NNP-BC, APRN; Bouchet-Horwitz, Julie MSN, FNP, IBCLC; Summers, Lisa DrPH, FACNM

Section Editor(s): Parker, Leslie A.

doi: 10.1097/ANC.0000000000000685
Human Milk Science: Special Series
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Background: The American Academy of Pediatrics and the National Association of Neonatal Nurses recognize that federal policies fail to reimburse for the provision of pasteurized donor human milk (PDHM) to the very low birth-weight neonate, and have encouraged members to advocate for the inclusion of PDHM into their respective state Medicaid programs.

Purpose: This article describes what occurred in New York State as advocates worked for reimbursement of PDHM reimbursement by Medicaid.

Method: Tactics utilized in New York have been presented with an advocacy framework to illustrate the necessary strategic foresight required for productive engagement within the healthcare policy arena.

Results: Examination of employed advocacy efforts targeted to remove known cost barriers associated with PDHM.

Implications for Practice: Full utilization of PDHM within intensive care.

Implications for Future Research: The necessity to engage in scholastic/evidence-based advocacy work.

School of Nursing, Yale University, Orange, Connecticut (Mr Schmaltz and Dr Summers); Marietta Neonatology in Marietta, Georgia (Mr Schmaltz); and The New York Milk Bank, Valhalla (Ms Bouchet-Horwitz).

Correspondence: Christopher H. Schmaltz, DNP, NNP-BC, APRN, 1578 Monroe Dr, NE STE F-138, Atlanta GA 30324 (nnpupenn@gmail.com).

Ms Bouchet-Horwitz is the Executive Director of The New York Milk Bank.

The authors declare no conflicts of interest.

© 2019 by The National Association of Neonatal Nurses