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Pa. updates Medicaid policy to support postpartum LARC insertion

Effective Dec. 1, Pennsylvania's Medicaid program will reimburse providers for the cost of providing long-acting reversible contraception (LARC) immediately postpartum, officials announced last week, Rewire reports.


About half of the pregnancies in the state are unintended (Anderson, Rewire, 11/22). Further, noting that LARC can help women space pregnancies, Pennsylvania Secretary of Health Karen Murphy in a press release said, "Back-to-back pregnancies are an increased risk to maternal health outcomes" (Linder, Pittsburgh Post-Gazette, 11/22).

According to the Pennsylvania Department of Human Services (DHS), "high up-front costs" can impede access to LARC. Under the current policy, the state's Medicaid program pays providers a bundled payment for labor and delivery that does not include the cost of LARC devices or provision (Rewire, 11/22).

Pennsylvania's announcement comes after the Centers for Medicare and Medicaid Services earlier this year urged state Medicaid programs to adopt policies that increase access the full range of contraceptive methods, including LARC (Women's Health Policy Report, 6/16). South Carolina in 2012 became the first state to revise its Medicaid policy to encourage providers to offer postpartum LARC insertion, according to Pew Charitable Trusts. Other states where Medicaid covers postpartum LARC administration include California, Georgia, Illinois and New York.

Policy update

The Pennsylvania DHS said it is updating its policy so that the Medicaid program will provide payment for LARC insertion in addition to the bundled payment for labor and delivery, helping to "eliminate the hurdle of high up-front costs" for such contraception and to incentivize hospitals to stock LARC (Rewire, 11/22). The state will also allocate federal funding to train providers in LARC insertion.

Loren Robinson, deputy secretary for health promotion and disease prevention at Pennsylvania DHS, said the policy change "will decrease [unintended] pregnancies in the commonwealth and allow providers to be more comfortable with educating their patients on [LARC], in general" (Pittsburgh Post-Gazette, 11/22).

DHS predicts that the policy change will lead to a 6 percent increase in LARC use in the state. In addition, Gov. Tom Wolf (D) said the policy change is expected to reduce unintended pregnancies, improve public health and yield financial savings for the state (Rewire, 11/22).