Review of Publicly Available State Reimbursement Policies for Removal and Reinsertion of Long-Acting Reversible Contraception

Abstract

Ekwutosi M Okoroh,1 Charlan D Kroelinger,1 Olivia R Sappenfield,2 Julia F Howland,2 Lisa M Romero,1 Keriann Uesugi,2 Shanna Cox1 1Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA; 2Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL, USACorrespondence: Charlan D Kroelinger, Chief, Maternal and Infant Health Branch, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS S107-2, Atlanta, GA, 30341, USA, Tel [phone], Email [email protected]: We examined reimbursement policies for the removal and reinsertion of long-acting reversible contraception (LARC).Patients and Methods: We conducted a standardized, web-based review of publicly available state policies for language on reimbursement of LARC removal and reinsertion. We also summarized policy language on barriers to reimbursement for LARC removal and reinsertion.Results: Twenty-six (52%) of the 50 states had publicly available policies that addressed reimbursement for LARC removal. Of these 26 states, 14 (28%) included language on reimbursement for LARC reinsertion. Eleven (42%) of 26 states included language on additional requirements for reimbursement for removal and/or reinsertion: five state policies included language with other requirements for removal only, three policies included language with additional requirements for reinsertion only, and three included language with additional requirements for both. Three state policies specified no restrictions be placed on reimbursement for removal and one specified no restrictions be placed on reimbursement for reinsertion.Conclusion: Half of the states in the US do not have publicly available policies on reimbursement for the removal and reinsertion of LARC devices. Inclusion of unrestricted access to these services is important for contraceptive choice and reproductive autonomy.Plain Language Summary: This review was done to understand how state policies reimburse providers who remove and then may reinsert a woman’s long-acting, reversible contraception (LARC) device. In this policy review, we found that more than half of all states reimburse providers for removing a LARC device. Of those states, half reimburse providers for reinserting a LARC device if a woman chooses it. Some states also identify reasons why state policies may or may not reimburse for LARC device removal or reinsertion. If women do not have the option to remove a LARC, they may not choose it, and this affects how they decide on the options to prevent a pregnancy.Keywords: contraception policy, LARC reimbursement, LARC removal, LARC reinsertion

Keywords

• contraception policy
• larc reimbursement
• larc removal
• larc reinsertion