Immediate Postpartum Contraception Coverage in Washington

New law requires insurance plans in Washington to reimburse hospitals and providers for Immediate Postpartum Contraception

Delivering clinicians have long recognized the importance of healthy birth spacing and patient access to postpartum contraception. Historically there have been major financial barriers to hospitals offering birth control – particularly long-acting reversible contraception (or LARC) like IUDs and implants – in their birth centers immediately after delivery. 

Starting January 1, 2023, Washington State law will require commercial insurance plans to cover the cost of immediate postpartum contraception provided in hospital and birth center settings as a separate payment from the standard labor and delivery payment. Medicaid plans are already required to reimburse for immediate postpartum contraception outside of this diagnostic related grouping.

HB 1651 signed by Governor Inslee will hold commercial insurance plans to the same standard as state Medicaid plans in two important ways:

  1. Providers will be allowed to bill separately for immediate postpartum contraception when provided in a hospital or birth center.
  2. Insurance plans will be prohibited from considering such devices, implants, services, or combinations thereof to be part of any payments for general obstetric procedures.

Many commercial insurers consider immediate postpartum methods – including expensive devices like IUDs and implants – “covered” under their plans because they roll the cost of providing these methods into the fixed DRG payment already negotiated with the hospital. This has led to confusion among both patients and providers. 

LARC Billing Guidelines

Starting January 1, 2023, all insurers must account for the true cost of all immediate postpartum contraceptives, which will reduce barriers to your hospital stocking these methods.*

Talk to your hospital administrators about how this new law can help you offer immediate postpartum contraception to your patients. For more information about Upstream’s pro bono program that includes clinician practicums, staff training, and other technical assistance to improve immediate postpartum contraception access, contact us.

*Contact the Office of the Insurance Commissioner if your patient’s immediate postpartum contraceptive care claim is denied.

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