Speak Up for Lactation Support
More dismantling of health care is in United HealthCare’s proposed ‘cost-reduction’ for billing code S9443. This change would limit access to lactation support. That affects many Maine families. It is important to speak out about this.
Call to Action
Gianna DeJoy has a Call to Action in her recent blog.
Please contact:
UHC regional network management office
950 Winter St. Suite 3800 Waltham, MA 02451
781-472-8650
Maine Insurance board
207-624-8475
Your legislators. This link will help you find your legislators. Health care is a significant issue in the current senatorial race.
We know insurance companies focus on profit and dollars. Still, we need to educate the decision makers.
Billing code S9443 is the one code that private practice IBCLCs use for home or independent office visits. The change would mean one could only bill for the parent, not the parent and child. How does that work in breastfeeding? And only one visit in 24 hours. How is that timely care?
Recent Reimbursement Advocacy
Recently MSBC successfully advocated for MaineCare to reimburse IBCLC care home visits and private practice. The bill was passed (unanimously). Promoting IBCLC home visits and independent clinics widens the range of lactation support for families, especially as hospitals close.
We are still awaiting the rulemaking and rate setting process, which is due to happen by the end of 2026. Once that information is in place and clear we will share it widely.
Our MaineCare bill was a step forward. UHC’s proposal is two steps backward.
UHC’s proposal would limit access as we are working to expand it. Contact before September 1st, 2026.
UHC regional network management office
950 Winter St. Suite 3800 Waltham, MA 02451
781-472-8650
Maine Insurance board
207-624-8475
Your legislators. This link will help you find your legislators.
Educating Decision Makers
It is necessary to educate the decision makers. Clearly, there is a lack of understanding about lactation, lactation professionals and the value of human breast milk. I’ve seen this unawareness and confusion in other instances. I have also seen some positive change.
One example was our testimonies for MaineCare coverage of Donor Human Milk. After sharing statistics about cost, reduced rates of N.E.C and more, a crucial question was asked. One senator queried “But why can’t we just give them formula?”. The biology of an infant’s immune system, the permeable gut lining, the quality of nutrition was made plain: This is why Donor Human Milk is important for all babies in the NICU.
This was finally understood and the bill was passed, unanimously.
In another situation, my colleagues and I in Massachusetts had a conversation with BlueCross/BlueShield administrators. As we talked, one said “I’ve never had a baby or breastfed. Why would a woman need help once she left the hospital?” An astounding revelation from one deciding about reimbursement. My colleagues and I adroitly described the various reasons why support is of great importance. Ultimately, BlueCross/BlueShield of MA included reimbursement for IBCLC home visit care in their policies.
How to Write A Letter
To get you started on writing a message, you can use the same form for how you document with patients. This format is: S-B-A-R Two lines for each letter, succinct, gets the point across.
Situation: You are opposed to this proposal to limit billing code S9443. Limiting lactation support adds to the problem, solves nothing.
Background: Lactation and breastfeeding require two people and require timely interventions.
Assessment: Without adequate support, lactation and breastfeeding rates decline. This affects the long term health of children and the parent.
Recommendation: Keep S9443 as it is, allowing IBCLCs and lactation professionals to bill for the breastfeeding dyad, and to see a patient whenever it is necessary, even if within 24 hours.
Here are more helpful guidelines for writing a letter, as mentioned in the previous blog. Your experience and opinion matter, say what you feel is effective.
United HealthCare may or may not be open to learning. Yet, it’s always worth sharing the facts. I say this to encourage you that what you know and feel is valid. Our advocacy work is to keep informing people in a number of ways.
Call to Action
Please speak up about this proposal. The deadline is September 1, 2026.
UHC regional network management office
950 Winter St. Suite 3800
Waltham, MA 02451
781-472-8650
Maine Insurance board:
Insurance.PFR@maine.gov
207-624-8475
Your legislators.This link will help you find your legislators.
This is one way to counteract the erosion of our health care rights. Thank you for your time and experience.