Natural Family Planning Insurance Coverage Will Continue After Federal Judge Issues Injunction

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Nurse practitioner Cami Jo Tice-Harouff will continue to be reimbursed for the fertility awareness-based methods (FABM) of birth control  — also known as natural family planning — she teaches her patients.

Federal district judge Jeremy Kernodle for the Eastern District of Texas in Tyler issued an injunction supporting Tice-Harouff and preventing a rule change that would likely end coverage.

Tice-Harouff is represented by the non-profit Christian legal defense group Alliance Defending Freedom (ADF).

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In 2016, the U.S. Department of Health and Human Services (HHS) adopted regulations that require contraception to be covered by health insurance plans. The regulations stated, “Additionally, instruction in fertility awareness-based methods, including the lactation amenorrhea method, although less effective, should be provided for women desiring an alternative method.”

In 2021, HHS changed the regulations and deleted the sentence about coverage for FABM.

The majority of Tice-Harouff’s practice consists of teaching and coaching women to use these natural methods of contraception.

“Many of my patients are dissatisfied with hormonal contraception,” Tice-Harouff told The Texan. She sees women of all faith backgrounds who want to use “a method that will help them take charge of their fertility.”

Her patients say they “feel more confident in understanding how their body is functioning, a greater ability to report deviations, and the impact of hormonal agents on their body.”

FABM is more than just learning a method; it involves many medical protocols. “The science has advanced and involves specialized training,” noted Tice-Harouff, who has a Doctor of Nursing Practice degree in Advanced Practice Nursing from Samford University.

Instruction in the natural methods usually requires patients to meet with her six times in the first few months of instruction. The sessions are covered at a reimbursement rate of approximately $300 to $450 per appointment, according to the court pleadings.

Tice-Harouff donates some of the proceeds to a non-profit clinic that provides health care to the needy, a press release by ADF stated.

ADF senior counsel Julie Blake said that the notice about the coverage changes was very confusingly written, inaccurate, and buried on the HHS website. Many who would be impacted by such a change, she stated, were unable to provide feedback and comments as required by law.

In making the change, ADF asserted that HHS did not follow the proper procedures. Kernodle agreed.

“​​Yet, when HRSA provided notice of its intent to adopt the 2021 Guidelines, the agency failed to give adequate notice of the elimination of coverage for FABM counseling,” he wrote in his opinion.

Tice-Harouff is very pleased with the decision and says her patients “are overjoyed” and that losing this coverage “could seriously burden their families.”

“There are providers all over the country who rely on this. The bottom line is that women shouldn’t be afraid of losing their doctor or their coverage due to back room bureaucrats.”

The injunction requires that the current language including FABM be maintained “until it is changed through a final rule (not an interim final rule) issued after notice to the public and an opportunity to comment consistent with the Administrative Procedure Act.”

According to Blake, HHS has said it will comply with the court injunction so that coverage of FABM will not be affected. She does not know if HHS will pursue changing the rule using the proper amendment process.





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