What's happening
This bill requires New York's Medicaid program to cover the cost of donor breast milk for certain medically vulnerable infants.
Why it matters
Targets the most vulnerable infants. The bill specifically covers infants with extremely low birth weight (≤1500 grams) or those with serious intestinal conditions, both of whom are at high risk for life-threatening complications like necrotizing enterocolitis if not fed human milk.
Supports families when maternal milk isn’t available. Coverage is only for cases where a licensed medical practitioner confirms that the infant or mother is medically or physically unable to provide or receive maternal breast milk, even after receiving optimal lactation support.
Limits cost and scope for sustainability. Medicaid will only pay for donor breast milk procured from certified nonprofit milk banks, ensuring both safety and cost control, and coverage is limited to inpatient settings and until the infant reaches 34 weeks corrected gestational age.
Potential to improve infant health outcomes and reduce costs. By enabling access to donor breast milk for high-risk infants, the bill could lower rates of costly complications and hospitalizations, leading to better health outcomes and possible long-term savings for the state’s Medicaid program.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Cover Donor Breast Milk
Plain English, a few words. Used as the page title.
Sponsors
1 Co-sponsor
History
- Referred to health
- Referred to health
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Cover Donor Milk for Infants
In Assembly Committee · Health · Sponsor Michaelle C. Solages
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1802
2019-2020 Regular Sessions
IN SENATE
January 16, 2019
Introduced by Sen. RIVERA -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the social services law, in relation to requiring medical assistance coverage for the cost of donor breast milk in certain circumstances
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 2 of section 365-a of the social services law is amended by adding a new paragraph (ff) to read as follows:
(ff) the cost of donor breast milk (PDHM), for inpatient use, for which a licensed medical practitioner has issued an order for an infant who is medically or physically unable to receive maternal breast milk or participate in breast feeding or whose mother is medically or physically unable to produce maternal breast milk or participate in breast feeding despite optimal lactation support. Such infant must: (i) have a documented birth weight of one thousand five hundred grams or less; or (ii) have a congenital or acquired intestinal condition, and is therefore at a high risk for development of necrotizing enterocolitis and/or infection. Coverage for donor breast milk (PDHM) shall continue until the infant is at an age of medical adjustment of thirty-four weeks corrected gestational age and such coverage shall be not less than the reasonable cost of such milk procured from a certified nonprofit milk bank, plus reasonable processing and handling fees.
§ 2. This act shall take effect on the first of January next succeeding the date on which it shall have become a law.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05023-01-9
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the social services law, in relation to requiring medical assistance coverage for the cost of donor breast milk in certain circumstances
Purpose
To ensure high risk, premature babies have access to one of the most effective measures of preventing death and disability.
Summary of provisions
Section one amends Social Services Law § 365-a(2) to provide Medicaid coverage of donor breast milk (PDHM) for inpatient use, ordered by a licensed medical practitioner for a high risk preterm infant who is unable to receive own mother's breast milk or the own mother is unable to provide. Coverage shall be for a reasonable cost of such milk procured from a certified nonprofit milk bank, plus a reasonable handl- ing fee.
Read the full memo (687 words)
Section two provides this act takes effect the first of January succeed- ing its enactment.
Justification
Premature infants, particularly those born with birth weight of 1,500 grams or less, are at high risk of developing necrotizing enterocolitis (NFC),.a. sudden onset intestinal disease affecting approximately 7% of these infants. The disease causes inflammation in the small intestines and in some cases (30%) intestinal perforation. Formula feeding and extreme prematurity increase the risks. Mortality from the disease is extremely high, ranging from 10-50%-. Among survivors, the disease increases the risk of infections, prolongs the,hospital stay, leads to feeding intolerance and dependence on intravenous nutrition, and may impart lifelong intestinal problems. Survivors of necrotizing entero- colitis have an increased risk of developmental disabilities such as cerebral palsy.
The own mother's breast milk is the optimal nutrition for every baby. In the case of premature infants, it has long been known that the great- est preventive measure for necrotizing enterocolitis is for the infant to be fed own mother's breast milk. Donor breast milk -(PDHM) which is pasteurized donated breast milk from screened and medically tested heal- thy lactating women, currently has the next best nutritional profile, especially in the digestibility of the proteins, the quality of the fat. Additionally, PDHM provides anti-infective factors, intestinal growth factors and hormones, as well as substances which promote the growth of healthy intestinal bacteria all of which have been shown to improve health in preterm infants. Of note, these protective factors are absent in the infant formulas. In a 2012 policy statement, the American Academy of Pediatrics recommended feeding preterm infants PDHM when maternal breast milk is not available. Several other organizations, including the Academy of Breast-feeding Medicine, the European Society for Pediatric Gastroenterology, Hepatology and Nutrition and its North American coun-
terpart, all agree providing this "medicine" for high-risk infants can be lifesaving, reducing the rate of NEC by a factor of two or more.
Unfortunately, not all mothers of premature babies are able or well enough to lactate despite lactation support, and must rely on pasteu- rized donor milk in order to most optimally nourish their high risk babies and also to provide them with this preventative measure. Pres- ently, PDHM is not covered by insurance companies or Medicaid in the state. At a cost of 2-3 times costs higher than formula, PDHM is unaf- fordable for many families who would benefit it. While the initial costs of PDHM may be more than formula, its use amongst those at risk of NEC would provide substantial costs savings to the health care system and the Medicaid program. While the number of infants in New York State who would be eligible for coverage of PDHM under this proposal is only 1.5%, these critically ill, very low birthweight, premature infants constitute the majority of the total Medicaid budget for neonatal care. With the use of PDHM expected to reduce the incidence of NEC by roughly 50%, such coverage would not only save lives but save considerable Medicaid dollars.
This bill is dedicated to Elizabeth Nostrand, a strong and caring woman who worked diligently to ensure that this become law.
Legislative history
Similar to S.65833 of 2016
Fiscal implications
Savings to the Medicaid program.
Effective date
This act shall take effect on the first of January next succeeding the date on which it shall have become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.