Billing Policy Change for Immediate Postpartum Voluntary Reversible Long-Acting Contraception

TennCare, Tennessee’s Medicaid program, provides coverage for voluntary reversible long acting contraceptive devices (VRLACs) including implants and intrauterine devices (IUD) through both an inpatient medical benefit and outpatient pharmacy benefit. TennCare’s three contracted managed care organizations (MCOs), Amerigroup, BlueCare, and United Healthcare Community Plan, have agreed to implement a billing policy change to allow TennCare enrollees who would choose a VRLAC contraceptive option to have more ready access to their device of choice immediately following delivery during an inpatient stay. TennCare’s three MCO will be implementing similar policies that will allow for reimbursement of the VRLAC device cost and the professional practitioner fee for insertion of the VRLAC to be paid in addition to the global payment associated with the labor and delivery encounter. This policy change takes effect November 2, 2017.

THA hosted a webinar for members on October 16, 2017 to provide information on VLARC, the processes for billing claims if inserted at the time of delivery, and resources available to educate providers. The link to the slides and recording is available here.

Additional Resources

 

THA OB Contact

Jackie Moreland
Clinical Quality Improvement Specialist
615.401.7439
jmoreland@tha.com

Chris Clarke
Senior VP for Clinical Services
615.401.7437
cclarke@tha.com

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