Raised Bill No. 5369 Summary

• Group health insurance policies must provide coverage for pasteurized donor breast milk and human milk products derived from donor breast milk starting January 1, 2021, when medically necessary and prescribed by a licensed physician, physician assistant, or advanced practice registered nurse.

• Donor breast milk coverage applies when an insured infant is medically or physically unable to receive maternal breast milk or the mother cannot produce sufficient quantities.

• Human milk product coverage applies to infants younger than six months of age or those with below-healthy body weight or congenital/acquired conditions placing them at high risk for necrotizing enterocolitis.

• The Commissioner of Public Health must establish a regulatory program by July 1, 2020, to oversee the donation, processing, and distribution of donor breast milk in Connecticut and require testing for drugs and adulterants including amphetamines, benzodiazepines, cocaine, opiates, methamphetamines, and nicotine.

• Medicaid coverage for pasteurized donor breast milk and human milk products is required under the same medical necessity conditions as private insurance, subject to federal law approval.