Review of Publicly Available State Policies for Long-Acting Reversible Contraception Device Reimbursement

• Authors: Lisa Romero, Centers for Disease Control and Prevention, Atlanta; Olivia R Sappenfield, University of Illinois Chicago; Keriann Uesugi, University of Illinois Chicago; Julia F Howland, University of Illinois Chicago; Charlan D Kroelinger, Centers for Disease Control and Prevention, Atlanta; Ekwutosi Okoroh, Centers for Disease Control and Prevention, Atlanta; Chioma Erondu, Centers for Disease Control and Prevention, Atlanta; Shanna Cox, Centers for Disease Control and Prevention, Atlanta
• Journal Title: JOURNAL OF WOMENS HEALTH
• Volume: Volume 31, Number 7
• Publisher: Mary Ann Liebert | 2022-07-01, Pages 1048-1056
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1089/jwh.2021.0361
• Subjects: Health Sciences, Epidemiology; Biology, Biostatistics
• Keywords: long-acting reversible contraception; LARC device reimbursement; state-level LARC reimbursement policy

Abstract

Background: Provider challenges to accessing long-acting reversible contraception (LARC) include level of reimbursement for LARC device acquisition and cost to stock. State-level LARC device reimbursement policies that cover a greater proportion of the cost of the LARC device and enable providers to purchase LARC upfront may improve contraceptive access. Materials and Methods: To summarize state-level policies that include language on LARC device reimbursement in the outpatient setting, we conducted a systematic, web-based review among all 50 states of publicly available LARC device reimbursement policies that include coverage of LARC devices as a medical or pharmacy benefit, the use of the 340B Drug Pricing Program to purchase LARC devices, and separate payment for LARC devices outside of the Medicaid Prospective Payment System (PPS) payment rate for Federally Qualified Health Centers or Rural Health Clinics. Results: Forty-two percent (21/50) of states with publicly available state-level policies included language on LARC device reimbursement. Among the states, 24% (5/21) had coverage policies as a medical benefit, 33% (7/21) as a pharmacy benefit, and 19% (4/21) as both a medical benefit and pharmacy benefit; 38% (8/21) used the 340B Program to purchase LARC devices; and 62% (13/21) indicated separate payment for LARC devices outside of the Medicaid PPS payment rate. Conclusion: State-level policies for LARC device reimbursement vary, highlighting differences in reimbursement strategies across the U.S. Future research could explore how the implementation of these payment methods may impact LARC device reimbursement and whether increased reimbursement may improve access to the full range of contraceptive methods.