BILL NUMBER: S3296

SPONSOR: HOYLMAN
 
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 depart-
ment.

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 regu-
lations. The department shall seek any necessary approvals of the feder-
al 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 intol-
erance, prevent NEC, and improve overall long-term health outcomes for
preterm infants. 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.

Donor human breast milk costs roughly $4.50 an ounce. Although it is
more expensive than formula, it is significantly less expensive than
long term NEC hospital stays.

 
PRIOR LEGISLATIVE HISTORY:

S.0061 of 2017-2018(Hoylman): Died in Health
A.6163 of 2017-2018(Solages): Died in Health
S.7570 of 2016 (Hoylman): Died in Health
A.8511 of 2015-2016(Solages): Died in Health

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect immediately.