title: The Impact of the Affordable Care Act on Funding for Newborn Screening Services.
abstract: OBJECTIVE
  The Affordable Care Act requires most health plans to cover the federal Recommended Uniform Screening Panel of newborn screening (NBS) tests with no cost sharing. However, state NBS programs vary widely in both the number of mandated tests and their funding mechanisms, including a combination of state laboratory fees, third-party billing, and other federal and state funding. We assessed the potential impact of the Affordable Care Act coverage mandate on states' NBS funding.
  
  
  METHODS
  We performed an extensive review of the refereed literature, federal and state agency reports, relevant organizations' websites, and applicable state laws and regulations; interviewed 28 state and federal officials from August to December 2014; and then assessed the interview findings manually.
  
  
  RESULTS
  Although a majority of states had well-established systems for including laboratory-based NBS tests in bundled charges for newborn care, billing practices for critical congenital heart disease and newborn hearing tests were less uniform. Most commonly, birthing facilities either prepaid the costs of laboratory-based tests when acquiring the filter paper kits, or the facilities paid for the tests when the kits were submitted. Some states had separate arrangements for billing Medicaid, and smaller facilities sometimes contracted with hearing test vendors that billed families separately.
  
  
  CONCLUSIONS
  Although the Affordable Care Act coverage mandate may offset some state NBS funding for the screenings themselves, federal support is still required to assure access to the full range of NBS program services. Limiting reimbursement to the costs of screening tests alone would undermine the common practice of using screening charges to fund follow-up services counseling, and medical food or formula, particularly for low-income families.
authors: University of Kentucky, Department of Health Policy and Management, Lexington, KY.
authors: Julia F
authors: JF
authors: Costich
authors: University of Pittsburgh, Department of Human Genetics, Pittsburgh, PA.
authors: Andrea L
authors: AL
authors: Durst
mesh_terms: D005380:Financing, Government / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000191:economics*; D058991:Patient Protection and Affordable Care Act / Q000191:economics* / Q000706:statistics & numerical data; D013219:State Government; D011795:Surveys and Questionnaires; D014481:United States