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Elizabeth M. Whitehorn, Director

Provider Notice issued 03/04/2024

 

To:
 All Medical Assistance Program Providers
​Date: ​March 4, 2024
​Re: Electric Breast Pump Change in Benefit Frequency without Prior Approval 

This notice informs providers of a change in policy for requesting an electric breast pump. This change affects both the Medicaid fee-for-service program and the managed care organizations (MCOs).

Effective with dates of service beginning January 1, 2024, the benefit frequency limit for an electric breast pump has been changed from one in five years without prior approval, to one per year without prior approval. An additional electric pump needed within one year of the previous pump will require prior approval.

Only the benefit frequency limit without prior approval has been changed. All other requirements remain the same.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the appropriate MCO.

 

Kelly Cunningham, Administrator
Division of Medical Programs