Texas nurse practitioner challenges health insurance coverage change

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

FABM, also known as natural family planning, can be used as a method of contraceptive. A woman will work with a team of doctors to determine when her fertility period 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 FABM counseling as eligible for insurance coverage. This change was mandated by the Health Resources and Services Administration (HRSA) in the District Court for the Eastern District of Texas. The HRSA changed its guidelines in Dec 2021, excluding the practice from coverage.

Attorneys from the religious non-profit Alliance Defending Freedom (ADF) represented Tice-Harouff to secure an injunction against the removal of insurance coverage for FABM counseling.

Tice-Harouff stated that the change was made without proper notice before adoption. Additionally, the change would result in lost income, and according to a news release from the ADF, allows the Biden Administration to impose “its own, preferred contraceptive methods on all women without even allowing the public to weigh in on that decision.”

According to the Federal Court order, as a counselor to individuals pursuing alternative means of contraception, 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 meet with Tice-Harouff six times during the first six months of counseling.

In the court order, Tice-Harouff alleges that fewer insurers will provide cost-free coverage of FABM counseling if such counseling is not specifically included in the guidelines. Additionally, based on her own experiences as a healthcare provider, fewer patients will seek FABM counseling if insurers fail to provide cost-free coverage, resulting in fewer patients seeking Tice-Harouff’s counseling services. This will also reduce the number of existing patients and fewer patient follow-up sessions.

The removal of FABM from HRSA guidelines would also mean that individuals seeking contraceptive methods outside of drugs or medical devices due to personal or religious preference would not be able to take advantage of insurance coverage, potentially forcing them to pay out-of-pocket expenses or forgo counseling altogether.

“Countless women rely on the expertise of medical professionals like Tice-Harouff to help them raise families in a manner consistent with their needs,” said ADF Senior Counsel Julie Marie Blake. “We’re pleased the court allowed insurance coverage to continue for the many women who choose fertility-awareness family planning...”

“Dr. Tice-Harouff’s patients, however, will suffer irreparable harm when they lose the cost-free coverage for [fertility awareness-based methods] counseling provided by the current Guidelines. Many will undoubtedly forego this care altogether 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 v. Johnson. “Defendants likely violated the law in eliminating cost-free coverage for FABM counseling.”

Tice-Harouff is a licensed nurse practitioner in Tyler with a doctorate in nursing practice. She is licensed in several other states and provides patients with instruction and counseling services in natural family planning.

Alliance Defending Freedom, according to its website, is a religious non-profit committed to protecting religious freedom, free speech, marriage and family, parental rights, and the sanctity of life. ADF attorneys have argued cases before the supreme court pertaining to religion in public schools, the Affordable Care Act, the legalization of same-sex marriage, business owners’ right to not provide services for same-sex marriage, and prayers before town meetings.