Insurance coverage

Texas nurse practitioner challenges health insurance coverage change

TYLER, Texas (KCBD) – Dr. Cami Jo Tice-Harouff, a nurse practitioner in Tyler, helped protect insurance coverage for fertility awareness-based methods (FABM) counseling.

FABM, also known as natural family planning, can be used as a method of contraception. A woman will work with a team of doctors to determine when her fertile window is using a variety of medical practices, including counseling, according to a National Library of Medicine Report.

Tice-Harouff was the plaintiff in a successful challenge against the removal of the FABM board as eligible for insurance coverage. This change was mandated by the Health Resources and Services Administration (HRSA) of the District Court for the Eastern District of Texas. The HRSA changed its guidelines in December 2021, excluding the practice of hedging.

Lawyers for the religious nonprofit Alliance Defending Freedom (ADF) represented Tice-Harouff in seeking an injunction against the removal of insurance coverage for the FABM counsel.

Tice-Harouff said the change was made without proper notice before adoption. Additionally, the change would result in lost revenue and, according to an ADF press release, allow the Biden administration to impose “its own preferred contraceptive methods on all women without even allowing the public to weigh in on this.” decision”.

According to the Federal Court order, as a counselor for people seeking alternative birth control, Tice-Harouff is reimbursed by insurers at a rate of $300 to $450 per counseling session. Each session lasts one to two hours and patients see Tice-Harouff six times during the first six months of consultation.

In the court order, Tice-Harouff alleges that fewer insurers will provide free coverage of FABM advice if that advice is not specifically included in the guidelines. Additionally, based on his own experiences as a healthcare provider, fewer patients will seek FABM advice if insurers do not provide free coverage, reducing the number of patients seeking Tice’s counseling services. – Harouff. It will also reduce the number of existing patients and fewer patient follow-up sessions.

Removing the FABM from the HRSA guidelines would also mean that people seeking birth control methods other than drugs or medical devices due to personal or religious preferences would not be able to take advantage of insurance coverage, which could force them to pay personal expenses or give up the consultation altogether.

“Countless women rely on the expertise of medical professionals like Tice-Harouff to help them raise their families in a way that meets their needs,” said ADF Senior Counsel Julie Marie Blake. . “We are delighted that the court has allowed insurance coverage to continue for the many women who choose fertility-focused family planning…”

“Dr. Tice-Harouff patients, however, will suffer irreparable harm when they lose free coverage for [fertility awareness-based methods] advice provided by the current Guidelines. Many will undoubtedly forego such care due to cost – or at least reduce the number or extent of counseling sessions,” the U.S. District Court for the Eastern District of Texas, Tyler Division, wrote in its opinion in Tice-Harouff c. Johnson. “Defendants likely violated the law by eliminating free coverage for FABM advice.”

Tice-Harouff is a Registered Nurse Practitioner in Tyler with a doctorate in nursing practice. She is licensed in several other states and provides natural family planning education and counseling to patients.

According to its website, Alliance Defending Freedom is a religious nonprofit organization committed to protecting religious freedom, freedom of speech, marriage and family, parental rights, and the sanctity of life. ADF lawyers have argued cases before the Supreme Court regarding religion in public schools, the Affordable Care Act, legalization of same-sex marriage, the right of business owners not to provide services for the same-sex marriage and prayers before municipal assemblies.

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