Congressman Morgan McGarvey Leads Efforts to Require Insurance Coverage of Special Nutrition Products for Premature Babies
This week, Congressman
"In 2011, our twins, Clara and Wilson, were born 14 weeks premature. They weighed a pound and a half and a pound and fifteen ounces; we spent 99 days in the NICU before coming home," said Rep.
"We need to be doing everything that we can to ensure that all families are able to meet the nutrition needs of their child," said Congresswoman
"The last thing any parent should be worrying about while their child is in the NICU is how they can afford the nutrition their child requires," said Rep.
"For families with premature babies in the NICU, human milk and nutrient supplements are essential for their child's growth and development - but, for many, they are cost-prohibitive. We must do more to ensure every family can access and afford the nutrition their child needs," said
Breastmilk alone is not calorically dense enough for most premature infants. Instead, these infants often rely on a more calorically dense, fortified breastmilk that packs a bigger punch than regular breastmilk alone. This human milk fortifier is derived from either human milk or cow's milk and then added to breastmilk to nutritionally enrich it. Thus, "human milk-derived human milk fortifier" is a fortifier made from human milk that is then added into human milk.
According to research, an exclusively human milk diet for premature babies is superior to one including cow's milk due to the risk of life-threatening diseases that can be caused by foreign proteins found in cow's milk. Many physicians recommend "human milk-derived human milk fortifiers" as the best solution. Although these products are increasingly recognized as lifesaving by neonatologists, many NICUs are not able to provide them to patients due to concerns over cost and insurance reimbursement. The Supporting Premature Infant Nutrition Act would require that both public and private insurance cover these products.
The Supporting Premature Infant Nutrition Act and letter to CMS is endorsed by: Conquering CHD,
"Black babies have the highest mortality rate in the country, and this bill is a step in the right direction to deliver vital nutrition to babies who spend their first days of life in the NICU," said Dr.
"The benefits of an exclusive human milk diet are proven to support the health and wellness of fragile preemies. In
The letter to CMS was signed by Reps.
The bill text of the Supporting Premature Infant Nutrition Act can be found HERE (https://mcgarvey.house.gov/imo/media/doc/supporting_premature_infant_nutrition_act.pdf).
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To: The Honorable
Dear Administrator Brooks-LaSure:
Supporting the health and dignity of the communities we serve is a top priority. As part of our ongoing partnership and collaboration with the
As you know, extremely premature infants require specialized nutrition. Clinical guidance recommends that all babies, but particularly premature babies, should receive human milk - either breast milk directly from their mother, or pasteurized donor human milk in other cases - as their primary form of nutrition. However, human milk alone is often not nutrient-dense enough to provide the full nutrition that premature babies need, especially very low birthweight babies.
Instead, these babies rely on fortifier, a supplement that can be made from either human milk or cow's milk containing essential nutrients and calories.
Human milk-derived human milk fortifier is preferred by many physicians because it is easier for a premature baby's digestive system to process and reduces the risk of life-threatening diseases that can be caused by foreign proteins (such as cow's milk). Premature infants are at risk of a range of diseases and complications, including necrotizing enterocolitis (NEC), a devastating disease of the bowel. NEC can come on suddenly and have devastating, and even fatal, consequences for preemies. Even babies that survive NEC often continue to suffer from its aftereffects. Clinical evidence suggests that one of the best ways of preventing NEC is by ensuring that premature infants are fed exclusively human milk. Although these products are increasingly recognized as lifesaving by neonatologists around the country, unfortunately, many NICUs are not able to utilize these products due to concerns over cost and insurance reimbursement.
Yet despite the upfront costs associated with the exclusive human milk diet, clinical research has found that these products, pasteurized donor human milk and human milk-derived human milk fortifier, can be significant cost savers. A newly released study found that the clinical benefits associated with the use of human milk-derived human milk fortifier (reductions in NEC, bronchopulmonary dysplasia, retinopathy of prematurity, and late-onset sepsis) was also associated with shorter NICU stays and cost savings ranging from
Given that Medicaid covers about 42% of mothers, ensuring that Medicaid reimburses and supports hospitals in carrying human milk-derived human milk fortifier for very low birthweight babies is essential./2
Thus, we write to ask that CMS support and encourage state efforts to cover human milkderived human milk fortifier products under Medicaid. Specifically, we encourage CMS to issue a bulletin to state Medicaid directors reminding them that such products may be eligible for state level coverage.
We hope that all parents can access the best quality of care for their kids. Ensuring access to necessary nutrition for premature infants is one vital step.
Sincerely,
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Footnotes:
1/ Swanson, J.R., Becker, A., Fox, J., Horgan, M., Moores, R., Pardalos, J., Pinheiro, J., Stewart, D., Robinson, T. (2023). Implementing an exclusive human milk diet for preterm infants:real-world experience in diverse NICUs.
2/ https://www.marchofdimes.org/peristats/data?reg=99&top=11&stop=154&lev=1&slev=1&obj=18
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Original text here: https://mcgarvey.house.gov/media/press-releases/congressman-morgan-mcgarvey-leads-efforts-to-require-insurance-coverage-of-special-nutrition-products-for-premature-babies
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