INDIANAPOLIS (WISH) — Hoosier moms could lose out on help in learning how to breastfeed if one insurance company doesn’t start covering care. The concern is prompting caregivers to sound the alarm.

Indy Lactation Care was founded about eight years ago, with a special focus on supporting families with newborns and providing guidance far after they walk out of hospital doors.

“We have the option of a clinic, but our goal is mostly to see moms in their homes whenever possible.” owner Kathy Thomas said.

Her team of board certified lactation consultants, who are also registered nurses, have helped countless moms in Indiana.

But, despite the team having the international gold standard certification and over 1,000 hours of clinical training, the state won’t license them. The reality is impacting insurance coverage.

“Certain insurance companies, including Anthem Blue Cross Blue Shield, which is a big provider, does not cover lactation consults because we are not licensed,” Thomas said.

For years, many lactation consultants across the country have used a third-party biller to get lactation coverage for moms with Anthem. But, earlier this summer, that biller said it could no longer help.

Thomas says over 80% of their patients have Anthem health insurance. In just the last month, nearly 40 Hoosier moms have lost out on breastfeeding care because Anthem won’t cover it and they can’t afford to pay for it out of pocket.

“The first visit that we give is 90 minutes to two hours, and that comes at a cost of $200, if we come to your home,” team member Monica Bird said. ‘With the clinic, we try to bring that price down to $140, so parents can see us here.”

Anthem says they do provide some lactation coverage, but cannot cover consultants because they are not state licensed.

It’s a problem that’s prompted action.

“A lot of our patients wrote letters, probably close to 100 letters that we sent to Anthem here in Indiana,” Thomas said.

“They are not given the opportunity to be cared for by an expert, and that affects their children’s health, their health and the next generation of their family,” Bird said.

Anthem offered this statement to I-Team 8.

“Anthem supports healthy moms and babies by covering a wide range of lactation services. Many hospitals, obstetricians, pediatricians, and midwife practices offer these services, which we reimburse through our standard claims process. Many of our members also choose to access lactation support through virtual providers, which offer added convenience. Currently, because the state does not license independent lactation services providers, they do not receive National Provider Identifier (NPI) numbers from the Centers for Medicare & Medicaid Services. Without an NPI number, we cannot establish contracts with or process claims from any healthcare provider, including independent lactation service providers. We are currently working to find solutions that would allow payment to independent lactation services providers.”

Indy Lactation Care says their team members have both NPI numbers and a group NPI number.

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