BILL NUMBER:  S7570

 TITLE OF BILL :  An act to amend the public health law, in relation
to reimbursement for donor human breast milk

 PURPOSE OR GENERAL IDEA OF BILL :

To provide reimbursement for donor human breast milk.

 SUMMARY OF SPECIFIC PROVISIONS :

Section 1. The public health law is amended by adding a new section
2505-b to read as follows:

§ 2505-b. Reimbursement for breast milk.

1. The department shall reimburse a medical care facility for
prescribed medically necessary donor human breast milk provided to a
recipient of medical assistance if:

(a) such recipient is:

(i) an infant under the age of three months;

(ii) critically ill; and

              

(iii) in the neonatal intensive care unit of the hospital;

(b) a person licensed to practice medicine and surgery orders the
donor human breast milk for the recipient;

(c) the department determines that the donor human breast milk is
medically necessary for the recipient;

(d) the parent or legal guardian of the recipient signs and dates an
Informed consent form indicating the risks and benefits of using
banked donor human breast milk; and

(e) the donor human breast milk is obtained from a donor human breast
milk bank that meets the quality requirements established by the
department.

2. An electronic prior authorization system that uses the best medical
evidence and care and treatment guidelines consistent with national
standards shall be used by the department to determine medical
necessi- ty.

3. The department shall promulgate rules and regulations necessary to
implement the provisions of this section.

4. The department shall implement and administer the provisions of
this section in a manner consistent with applicable federal laws and
regulations. The department shall seek any necessary approvals of the
federal government that are required for the implementation of this
section.

 JUSTIFICATION :

There is no current system to reimburse a medical care facility for
prescribed medically necessary donor human breast milk provided to a
recipient of medical assistance. The ideal source of nutrition for
infants is Human breast milk. Mothers of preterm infants face
difficulty producing adequate amounts of breast milk to sustain their
premature infants; which places the infant at risk for developing
necrotizing enterocolitis (NEC). This is why the need for donor breast
milk has become a necessary, desirable, and routine option to support
preterm infants. North American donor milk is pasteurized at 62.5 lc
for 30 minutes to remove any possible infectious or bacterial
contaminants; although many bioactive and immunity compounds are
either entirely or partially inactivated during this process.

Preterm infant ingestion of donor milk has show to reduce feeding
intolerance, prevent NEC, and improve overall long-term health
outcomes for preterm infants. There are concerns surrounding loss of
key biological components in donor milk due to pasteurization and
storage, but this should not be a deterrent nor a factor for denial of
donor milk. Donor Human breast milk should become a standardized
component as a holistic and main approach of health care for
preterm/premature infants. Banked donor Human breast milk is safe and
effective. According to the Human Milk Banking Association of North
America, quality control is ensured as part of an adherence to
mandatory inspections and guidelines.

Considering that donor human breast milk costs roughly $4.50 an ounce,
although it is more expensive than formula, its significantly less
expensive than long term NEC hospital stays. It should also be
considered that such critical and necessary medical supplies, as donor
human breast milk, should be covered by medicaid for low income
families.

 PRIOR LEGISLATIVE HISTORY :

None.

 FISCAL IMPLICATIONS :

To be determined.

 EFFECTIVE DATE :
This act shall take effect immediately.