{"id":15173,"date":"2022-07-01T08:12:04","date_gmt":"2022-07-01T13:12:04","guid":{"rendered":"https:\/\/naturalwomanhood.org\/?p=15173"},"modified":"2025-01-17T13:56:56","modified_gmt":"2025-01-17T19:56:56","slug":"methodes-de-sensibilisation-a-la-fertilite-couverture-dassurance","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/fr\/fertility-awareness-methods-insurance-coverage\/","title":{"rendered":"Le droit au remboursement par l'assurance de votre formation \u00e0 la m\u00e9thode bas\u00e9e sur la connaissance de la fertilit\u00e9 est d\u00e9sormais menac\u00e9\u00a0\u00a0"},"content":{"rendered":"

Note de l'\u00e9diteur : En d\u00e9cembre 2022, un tribunal f\u00e9d\u00e9ral a d\u00e9cid\u00e9 d'autoriser la mise en \u0153uvre de l'accord de libre-\u00e9change entre l'Union europ\u00e9enne et l'Union europ\u00e9enne. rejet\u00e9e<\/a> la tentative ill\u00e9gale de l'administration Biden de mettre fin \u00e0 la couverture d'assurance pour l'enseignement de la FABM. En juillet 2023, ce m\u00eame tribunal ordonn\u00e9 <\/a>l'administration Biden pour couvrir $65.000 de frais d'avocats encourus par le Dr. Cami Jo Tice-Harouff pendant le proc\u00e8s. <\/em><\/p>\n\n\n\n

Comment l'administration actuelle du minist\u00e8re de la sant\u00e9 et des services sociaux tente de l'\u00e9liminer  <\/h2>\n\n\n\n

Si les m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9 (FABM) sont un \u00e9l\u00e9ment important de la politique de sant\u00e9 publique, elles n'en sont pas moins importantes. durable<\/a>L'apprentissage d'une m\u00e9thode, option de planification familiale rentable pour de nombreuses femmes et de nombreux couples, s'accompagne d'un co\u00fbt initial compris entre $100 et $500, en fonction de la m\u00e9thode et de l'importance du soutien personnel n\u00e9cessaire. Comme nous l'avons appris lors du lancement de notre Fonds de bourses d'\u00e9tudes de la FABM<\/a> ici \u00e0 Natural Womanhood, plusieurs familles peuvent \u00eatre confront\u00e9es \u00e0 la difficult\u00e9 de financer cette formation au moment o\u00f9 elles en ont le plus besoin.  <\/p>\n\n\n\n

Mais en 2016, l'\"enseignement des m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9\" a \u00e9t\u00e9 ajout\u00e9 \u00e0 la liste des \"soins pr\u00e9ventifs et des d\u00e9pistages\" pour lesquels la loi sur les soins abordables (ACA) interdit aux assureurs d'imposer des mesures de partage des co\u00fbts aux patients. En d'autres termes, depuis 2016, les assureurs sont tenus de prendre en charge les cours sur les FABM lorsqu'ils sont dispens\u00e9s par un professionnel de la sant\u00e9 agr\u00e9\u00e9. Bien que ce changement ait \u00e9t\u00e9 bienvenu et qu'il ait constitu\u00e9 une grande victoire pour l'industrie des FABM, il est aujourd'hui contest\u00e9 par le minist\u00e8re de la sant\u00e9 et des services sociaux (HHS) de l'administration Biden.  <\/p>\n\n\n\n

Dans cet article, nous examinons ce qui a chang\u00e9 en 2016, ce que cela signifie en pratique et comment les r\u00e9centes actions du HHS de l'administration Biden pourraient menacer ce changement.  <\/p>\n\n\n\n

Directives de la HRSA sur les services pr\u00e9ventifs pour les femmes en mati\u00e8re de contraception : Ce qui a chang\u00e9 en 2016 <\/span><\/h2>\n\n\n\n

En 2016, pour la premi\u00e8re fois, l'\"enseignement des m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9\" a \u00e9t\u00e9 inclus dans la rubrique \"Couverture des contraceptifs\" de l'assurance maladie. \"Lignes directrices sur les services pr\u00e9ventifs pour les femmes<\/a> \u00e9tablies par la Health Resources & Services Administration (HRSA) du HHS. Ces lignes directrices imposent la couverture de certains services dans le cadre des r\u00e9gimes de sant\u00e9 de groupe et comportent des exigences sp\u00e9cifiques en ce qui concerne la couverture des services de contraception. <\/p>\n\n\n\n

Sous la rubrique Contraception dans l'ann\u00e9e 2016<\/a> et Versions 2019<\/a> des lignes directrices, nous lisons : <\/p>\n\n\n\n

\n

\"La Women's Preventive Services Initiative recommande que les adolescentes et les femmes adultes aient acc\u00e8s \u00e0 une gamme compl\u00e8te de contraceptifs contr\u00f4l\u00e9s par les femmes afin de pr\u00e9venir les grossesses non d\u00e9sir\u00e9es et d'am\u00e9liorer les r\u00e9sultats des naissances. <\/p>\n<\/blockquote>\n\n\n\n

Suit une liste exhaustive de 18 m\u00e9thodes contraceptives diff\u00e9rentes, pour lesquelles le partage des co\u00fbts est interdit. Ce qui a chang\u00e9 en 2016, c'est qu'\u00e0 la suite de la liste des m\u00e9thodes contraceptives conventionnelles, il y avait cette phrase importante : <\/p>\n\n\n\n

\n

\"En outre, une formation aux m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9, y compris la m\u00e9thode de l'am\u00e9norrh\u00e9e lact\u00e9e, bien que moins efficace, devrait \u00eatre dispens\u00e9e aux femmes qui souhaitent une m\u00e9thode alternative\". <\/p>\n<\/blockquote>\n\n\n\n

On ne saurait trop insister sur l'importance de cette \u00e9tape dans la reconnaissance des FABM en tant que forme valable de planification familiale dans le monde de la m\u00e9decine et de l'assurance maladie. Bien s\u00fbr, nous aurions pu nous passer de la partie \"bien que moins efficace\" (ce qui est terriblement inexact<\/a>), mais nous accepterons toujours les am\u00e9liorations progressives lorsque nous pourrons les obtenir (surtout si cela signifie que davantage de femmes et de couples ont enfin acc\u00e8s \u00e0 ces m\u00e9thodes !) <\/p>\n\n\n\n

En pratique, l'inclusion des FABM dans la rubrique \"contraceptifs\" des lignes directrices signifie que l'enseignement des FABM est devenu une d\u00e9pense couverte par l'ACA. Mieux encore, ce changement s'applique aux r\u00e9gimes d'assurance des employ\u00e9s de l'\u00c9tat et des collectivit\u00e9s locales, aux r\u00e9gimes des employ\u00e9s priv\u00e9s, aux r\u00e9gimes d'assurance Medicare et Medicaid, et aux r\u00e9gimes d'assurance de l'ACA.  <\/p>\n\n\n\n

Comment la couverture de l'instruction FABM fonctionne-t-elle dans le cadre de l'ACA ? <\/h2>\n\n\n\n

Il s'agit bien s\u00fbr d'une excellente nouvelle pour de nombreux utilisateurs actuels et futurs des FABM. Elle ne s'applique pas seulement \u00e0 celles qui utilisent les FABM pour la planification familiale, mais aussi \u00e0 celles qui utilisent les diagrammes pour des raisons m\u00e9dicales (comme le traitement de la st\u00e9rilit\u00e9 ou des probl\u00e8mes li\u00e9s au cycle menstruel).  <\/p>\n\n\n\n

Selon les lignes directrices de l'ACA de 2016, l'assistance suppl\u00e9mentaire des instructeurs (qui co\u00fbte environ $50 par session) peut \u00eatre couverte lorsque les femmes et les couples naviguent dans ces questions, \u00e0 condition que l'instructeur soit un professionnel m\u00e9dical agr\u00e9\u00e9 ou couvert par l'agr\u00e9ment d'un professionnel m\u00e9dical. En pratique, cela permettait aux professionnels de la sant\u00e9, tels que les gyn\u00e9cologues-obst\u00e9triciens, les m\u00e9decins de famille, les assistants m\u00e9dicaux ou les m\u00e9decins de famille, de b\u00e9n\u00e9ficier d'une aide financi\u00e8re. infirmi\u00e8res praticiennes<\/a>Dans certains cas, les m\u00e9decins ont d\u00e9cid\u00e9 de s'associer \u00e0 des instructeurs non agr\u00e9\u00e9s pour dispenser l'enseignement FABM \u00e0 leurs patientes. (Dans ces cas, la licence de l'obst\u00e9tricien, etc., a \u00e9t\u00e9 utilis\u00e9e pour obtenir le remboursement de l'enseignement par l'assurance).  <\/p>\n\n\n\n

Depuis 2016, et jusqu'\u00e0 r\u00e9cemment, vous pouvez demander \u00e0 votre professionnel de la sant\u00e9 de v\u00e9rifier aupr\u00e8s de votre assureur si ces services sont couverts, en utilisant les codes de traitement appropri\u00e9s (note de bas de page 1). Notez toutefois que l'application des lignes directrices dans le cadre des programmes Medicaid peut varier d'un \u00c9tat \u00e0 l'autre (note de bas de page 2). <\/p>\n\n\n\n

Aujourd'hui, cette r\u00e8gle est remise en question et la couverture de l'instruction FABM est menac\u00e9e <\/h2>\n\n\n\n

Malheureusement, tout ce qui pr\u00e9c\u00e8de pourrait bient\u00f4t devenir une question discutable.  <\/p>\n\n\n\n

En octobre 2021, le minist\u00e8re de la sant\u00e9 et des ressources humaines a publi\u00e9 un nouvel avis<\/a> sur un projet de recommandation concernant les recommandations relatives \u00e0 la fourniture de contraceptifs dans le cadre des lignes directrices sur les services pr\u00e9ventifs pour les femmes soutenues par la HRSA.  <\/p>\n\n\n\n

La recommandation pr\u00e9tendait seulement demander s'il fallait ajouter les pr\u00e9servatifs \u00e0 la liste des m\u00e9thodes contraceptives, mais dans la liste des contraceptifs couverts, elle n'incluait plus la phrase concernant l'enseignement des m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9. Il n'est pas clair s'il s'agit d'une omission intentionnelle dans le but de supprimer les m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9 de la ligne directrice initiale ou d'un oubli de la part du HHS.  <\/p>\n\n\n\n

N\u00e9anmoins, le HHS a ouvert une p\u00e9riode de consultation publique de 30 jours sur le projet de r\u00e8glement, qui s'est achev\u00e9e le 31 novembre 2021. Plusieurs organisations FABM, dont Natural Womanhood, ont publi\u00e9 des commentaires en r\u00e9ponse<\/a>mais ces commentaires n'ont pas \u00e9t\u00e9 rendus publics \u00e0 ce jour, et aucune r\u00e9ponse \u00e0 ces commentaires n'a \u00e9t\u00e9 rendue publique.  <\/p>\n\n\n\n

Puis, en d\u00e9cembre 2021, le HHS a officiellement supprim\u00e9 \"l'enseignement des m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9\" de sa liste des services de contraception couverts. Il l'a fait sans pr\u00e9voir de p\u00e9riode d'avis et de commentaires, ni fournir de justification pour cette suppression, deux conditions pourtant requises par la loi sur la proc\u00e9dure administrative (Administrative Procedure Act), selon l'Alliance Defending Freedom<\/a> (ADF). L'ADF poursuit actuellement le gouvernement f\u00e9d\u00e9ral pour violation de la loi sur la proc\u00e9dure administrative au nom d'un instructeur FABM et d'une infirmi\u00e8re praticienne du Texas, le Dr Cami Jo Tice-Harouff, mais s'il n'obtient pas gain de cause, la nouvelle r\u00e8gle entrera en vigueur en d\u00e9cembre 2022 et la couverture de l'enseignement des m\u00e9thodes fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9 appartiendra litt\u00e9ralement au pass\u00e9.  <\/p>\n\n\n\n

Le minist\u00e8re de la sant\u00e9 et des services sociaux va-t-il revenir sur les progr\u00e8s accomplis en mati\u00e8re de sant\u00e9 des femmes en supprimant la couverture du FABM ?<\/h2>\n\n\n\n

R\u00e9dactrice en chef de Natural Womanhood Grace Emily Stark comment\u00e9<\/a> Il s'agit ici d'annuler cette couverture, non seulement pour les couples qui veulent apprendre \u00e0 conna\u00eetre leur fertilit\u00e9 \u00e0 des fins de planification familiale, mais aussi pour les femmes qui veulent l'utiliser pour diagnostiquer l'infertilit\u00e9, pour diagnostiquer les probl\u00e8mes de cycle et pour les traiter. C'est vraiment d\u00e9courageant\". <\/p>\n\n\n\n

Il y a eu des progr\u00e8s \u00e0 c\u00e9l\u00e9brer lorsque la plus haute autorit\u00e9 de sant\u00e9 publique des \u00c9tats-Unis a reconnu les FABM comme une m\u00e9thode valable de planification familiale et a exig\u00e9 que son enseignement soit couvert par l'assurance au m\u00eame titre que les autres m\u00e9thodes de planification familiale. Cette d\u00e9cision a permis aux femmes et aux couples de disposer d'un plus grand nombre de choix en mati\u00e8re de planification familiale et d'acc\u00e9der \u00e0 un outil important pour le suivi de leur sant\u00e9. La tentative actuelle de retirer l'enseignement des FABM de la couverture d'assurance de l'ACA est un pas en arri\u00e8re et un affront aux femmes et aux couples qui ont besoin de ces m\u00e9thodes de planification familiale efficaces et sans effets secondaires.\u00a0\u00a0<\/p>\n\n\n\n

\u00cates-vous un patient, un prestataire de soins de sant\u00e9 ou un instructeur FABM qui a obtenu une couverture d'assurance ou un remboursement pour avoir re\u00e7u ou dispens\u00e9 un enseignement FABM ? Faites-nous part de votre exp\u00e9rience dans les commentaires.  <\/em><\/h3>\n\n\n\n

<\/p>\n\n\n\n

Notes de bas de page<\/em>: <\/p>\n\n\n\n

Note de bas de page 1 : La modification de 2016 peut ou non s'appliquer \u00e0 certaines personnes non conformes \u00e0 l'ACA, \"droits acquis<\/a>\"Il est donc n\u00e9cessaire de v\u00e9rifier la conformit\u00e9 \u00e0 l'ACA avant de d\u00e9poser une demande d'instruction FABM. (D'apr\u00e8s la transcription de ce podcast<\/a> publi\u00e9 par le National Clinical Training Center for Family Planning et le Family Planning National Training Center, le code CPT correct pour quelqu'un qui apprend le FABM pour la planification familiale serait H1010, avec le code de diagnostic Z30.02 s'il s'agit d'\u00e9viter une grossesse, ou Z31.61 s'il s'agit d'obtenir une grossesse. Notez que des codes diff\u00e9rents seraient utilis\u00e9s si l'objectif \u00e9tait diff\u00e9rent, comme un examen de sant\u00e9 ou un traitement ax\u00e9 sur les probl\u00e8mes, selon la m\u00eame transcription de podcast). <\/p>\n\n\n\n

Note 2 : Un autre obstacle \u00e0 la couverture consiste \u00e0 savoir si le plan Medicaid de l'\u00c9tat couvre la formation FABM. D'apr\u00e8s le le CDC,<\/a> tout \u00c9tat ayant adopt\u00e9 l'expansion Medicaid de l'ACA qui \"\u00e9tend l'\u00e9ligibilit\u00e9 Medicaid aux personnes non \u00e2g\u00e9es ayant un revenu annuel \u00e9gal ou inf\u00e9rieur \u00e0 133 % du niveau de pauvret\u00e9 f\u00e9d\u00e9ral ($16.611 pour une personne ou $34.247 pour une famille de 4 personnes en 2019)\". sont tenus de couvrir l'ensemble des services pr\u00e9ventifs requis par la r\u00e8gle finale relative aux prestations de sant\u00e9 essentielles (EHB)<\/strong>.\" Selon la Kaiser Family Foundation (KFF), 39 \u00c9tats et DC<\/a> ont adopt\u00e9 l'extension de Medicaid. Dans les \u00c9tats qui n'ont pas mis en \u0153uvre l'extension de Medicaid dans le cadre de l'ACA, les patients doivent v\u00e9rifier ce que leur plan Medicaid d'\u00c9tat couvre dans le cadre des services pr\u00e9ventifs pour les femmes. <\/p>\n\n\n\n

Il convient de noter que la L'\u00c9tat du Maryland, qui a adopt\u00e9 un code en 2018<\/a> qui d\u00e9finit et exige sp\u00e9cifiquement la couverture des FABM, en \u00e9num\u00e9rant les diff\u00e9rentes m\u00e9thodes couvertes, les r\u00e9gimes soumis \u00e0 ce code et les b\u00e9n\u00e9ficiaires (professionnels de la sant\u00e9 agr\u00e9\u00e9s). Il n'est pas fait mention de la couverture des outils FABM tels que les moniteurs d'hormonoth\u00e9rapie. <\/p>","protected":false},"excerpt":{"rendered":"Note de la r\u00e9daction : En d\u00e9cembre 2022, un tribunal f\u00e9d\u00e9ral a rejet\u00e9 la tentative ill\u00e9gale de l'administration Biden de mettre fin \u00e0 l'assurance...","protected":false},"author":2,"featured_media":15174,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5183,5266],"tags":[6378,5707,4421],"class_list":{"0":"post-15173","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-birth-control-issues","8":"category-in-the-news","9":"tag-birth-control-alternative","10":"tag-birth-control-risks","11":"tag-natural-birth-control","12":"cs-entry","13":"cs-video-wrap"},"acf":[],"yoast_head":"\nInsurance coverage of fertility awareness method instruction is in jeopardy<\/title>\n<meta name=\"description\" content=\"Like other family planning options, fertility awareness instruction is covered by insurance as preventive care. 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