SALT LAKE CITY — A state lawmaker made a pitch Wednesday at the Capitol for a bill that would allow Utahns with Medicaid to have an IUD placement covered by that insurance while they're at a hospital to give birth.

Currently, Medicaid does cover the use of an intrauterine device as a method of birth control. But because of regulations around billing mothers who are in the hospital for a baby delivery, the implementation of that device is not covered during that specific visit, explained Rep. Ray Ward, R-Bountiful.

"Medicaid says, 'We pay for these services at every other time and every other day,'" Ward said in a presentation to members of the Utah Legislature's Health and Human Services Interim Committee. "But when a woman is in a hospital delivering a baby, then on that day (Medicaid doesn't) pay extra for those services."

Ward said that's because of regulations surrounding a rigidly set payment, called a bundle, that Medicaid makes to health providers for clients of the federal insurance program during a delivery stay. However, Utah is one of just seven states that have not obtained an exception to that rule as it pertains to the placement of an IUD, he said.

"It has been only over the last five to 10 years that it has been realized that using these devices in the postpartum setting is best medical care, (that) if a woman wants it, its safe and effective and convenient to take care of it (immediately)," Ward said.

A bill that Ward has prepared, called Family Planning Services Amendments, would instruct the Utah Department of Health to seek a waiver allowing Medicaid to cover IUD placement during a women's baby delivery hospital stay.

Because Medicaid currently doesn't cover an IUD placement during a delivery stay, Ward said, "hospitals aren't willing to stock them and make them available to women at that time."

Under his bill, the Legislature would be "unraveling the billing rules that have prevented us from doing best medical practice," he said.

Ward said a "decreased number of abortions … has been found consistently among other states that have provided these services to women," and his bill would save the state money.

"Closely spaced births, where a woman gets pregnant again immediately after (giving birth), have a higher risk for being a preterm birth," he said.

The medical costs incurred with such a birth are so expensive, Ward said, that "if you save even two or three of those, that also reduces the state’s costs."

Such policies have been shown elsewhere to reduce the number of enrollees returning to Medicaid upon becoming pregnant again within a short amount of time, he said, further saving the state money.

Because an IUD can be costly, getting it insured for a woman on Medicaid during her delivery hospital stay can ultimately reduce the need for reliance on other governmental assistance, such as the Women, Infants and Children food program, Ward said.

"There aren’t very many areas of health care where we have really, really solid evidence that providing a service both benefits the individual but also saves our budget money," he said. "But this is one of those areas."

If a woman were to visit their doctor several weeks later to get an IUD, Medicaid would cover the procedure at that time, but "she might not be on Medicaid anymore because now she's not pregnant," Ward said.

"She might … miss the chance to get that service," he said.

Ward said his bill would ensure that less people fall through the cracks in getting a treatment critical to the well-being of themselves and their family.

"It would basically get family planning services to women under the (federal) poverty level," he said.

Based on other states' data, Utah could expect $2 to $3 in savings for each dollar spent implementing the policy change, Ward said. He predicted the annual cost associated with the change would amount to about $1 million per year, paired with $9 million per year in federal Medicaid matching funds.

But Ward said a finalized fiscal note for his bill is still a week or two away.

Rep. Paul Ray, R-Clearfield, pressed for more specifics on the bill's financial ramifications, asking, "What are we spending on these problems now that we're trying to prevent?"

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"Without a fiscal note, I'm just at this point not comfortable committing to a bill until what we see what the total cost is. … I don't know the cost, and I know there are going to be a lot of requests again this year," Ray said.

Ward said he would be happy to reintroduce his bill to the committee in November, after a fiscal note had been added.

The bill received backing from Emma Chacon, director of Medicaid operations for the Utah Department of Health, who said the legislation makes sound financial sense for the state.

"As far as Medicaid is concerned, we're on board with this particular approach," Chacon told the committee, "and we think that it's really a good deal, basically knowing that it's 90 percent federal funds to provide a very valuable service to the community."

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