Collaborative effort across Florida’s medical schools results in a statute expanding Medicaid coverage to include donor breastmilk

More Florida babies will have access to donor breastmilk with the recent passing of a bill in the Florida Legislature allowing Medicaid to help cover the cost. The bill, signed by Gov. Ron DeSantis last month, will become law July 1, 2022, and will greatly expand access to donor breastmilk for babies in neonatal intensive care units (NICUs) across the state. Hitherto, Florida Medicaid typically only covered infant formula for hospitalized babies who did not have access to their mothers’ milk.

The report that helped create the bill was provided by the Florida Medical Schools Quality Network (FMSQN), a cooperative of research, clinical, and educational experts from Florida’s medical schools that aims to improve quality of care in Florida’s Medicaid Program. FMSQN worked with USF Health College of Public Health alumnae Jan Gorrie, of Ballard Partners, to help navigate the bill through Florida Legislature’s bill processes. The FMSQN report was commissioned by the Agency for Health Care Administration.

“This collaboration among academic clinicians, State government policy makers, child advocates, government affairs professionals, and legislators converted data to action in supporting evidence-based access to donor breastmilk for Florida’s infants, and serves as an example of opportunities to improve health outcomes for infants, children, and adolescents in Medicaid programs.  We would like to thank Senator Lauren Book and Representative Fiona McFarland for sponsoring this legislation, and for Governor DeSantis’ timely approval during this time of a national critical formula shortage” said Charles J. Lockwood, MD, MHCM, senior vice president of USF Health, dean of the USF Health Morsani College of Medicine, and president of the FMSQN.

FMSQN member organizations include: Florida International University Herbert Wertheim College of Medicine; Florida State University College of Medicine; Lake Erie College of Osteopathic Medicine; Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine; Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine; University of Central Florida College of Medicine; University of Florida College of Medicine; University of Miami Leonard M. Miller School of Medicine; and the USF Health Morsani College of Medicine.

FMSQN was instrumental in conducting a survey of Florida’s NICUs current usage of donor human milk. The results and subsequent meetings with state legislators informed the crafting of Florida Senate Bill (SB) 1770 / House Bill (HB) 1577, which mandated Florida Medicaid coverage of pasteurized donor human milk (PDHM) and derivatives by accredited donor human milk banks and regulatory agency approved private milk banks.

Data showed that, if these NICUs did not provide PDHM, there would be an estimated increase of 138 more infants per year developing necrotizing enterocolitis (NEC), a potential fatal, severe gastrointestinal disease frequently requiring surgery and long-term nutritional support at an annualized cost of $5,175,000. Thus, PDHM use in Florida would avoid an estimated $4 million in health care expenditures annually, and may save more when the hospital readmissions, home health care visits, and emergency department visits are considered that were not factored into the calculations.

“The initiative was a success because of a team effort with academic health centers, State leaders, child and mother advocates, and community stakeholders,” Dr. Lockwood said. “And it’s these fragile babies in our hospitals who will benefit the most from this successful piece of legislation.”