MedicaidCoverageMedium impact
Request for Comment - Adding lactation consultants to Medicaid State Plan - Comments due April 16, 2020
Oregon Health Plan·OR · OB-GYN, Pediatrics, Family Medicine +1 more·Public notice
We identified it
Jun 20, 2026
Summary
Oregon Health Authority proposes to amend the Medicaid State Plan to add International Board Certified Lactation Consultants as an eligible provider type for Medicaid services. This expands coverage beyond hospital-based medical professionals to include independently licensed lactation consultants, with estimated federal costs of $9,513 in FFY 2020 and $62,392 in FFY 2021.
Action Required
By April 16, 2020: Medical billing leadership should review this request for comment period and submit formal feedback to jesse.anderson@dhsoha.state.or.us if the practice employs or refers to lactation consultants. After CMS approval of the State Plan Amendment: Billing team must update credentialing procedures to recognize lactation consultant provider types in the Oregon Medicaid system, establish appropriate billing workflows for lactation consultant services, and train billing staff on claim submission for this new provider category. Failure to implement proper billing infrastructure may result in claim denials or payment delays for lactation services once the amendment becomes effective.