Providence breaks silence on birth control
Employees of Providence Health & Services, the largest private employer in Spokane, were notified Tuesday that despite religious objections, the Catholic nonprofit organization covers their prescription contraceptives – and has since 2004.
It was apparently the first time hospital employees – some of whom have been purchasing birth control pills – were specifically told of the change in their coverage under Providence’s self-insurance plan. Instead, employees were told that there were changes in their prescription drug coverage and that they should consult their benefits package, which is posted on the Internet.
The company operates Sacred Heart Medical Center and Holy Family Hospital in Spokane, Deer Park Hospital, Mount Carmel Hospital in Colville and St. Joseph’s Hospital in Chewelah.
“Sacred Heart had an obligation to inform its employees of this change in coverage. Instead they chose to keep it quiet,” said Paula Williams, a registered nurse at Sacred Heart, who has spent hundreds of dollars on prescription contraceptives since 2004. “Now the insurance company will have to spend extra time and effort reimbursing people’s money.”
Providence employees at Sacred Heart were sent e-mails Tuesday from management promising to do just that.
“If you have purchased these medications as an out-of-pocket expense since the effective date, Sacred Heart will work with the third-party administrator to make sure you are reimbursed appropriately,” read the e-mail sent to the medical center’s employees the day after it was contacted by The Spokesman-Review about prescription contraception coverage.
Civil rights violation
Since 1998, at least 19 states, including Washington, have enacted laws requiring health insurers to provide comprehensive coverage of all contraceptives approved by the U.S. Food and Drug Administration.
In 2001, a federal district court in Seattle, ruling in the case of Erickson v. Bartell Drug Co., found that an employer’s exclusion of prescription drugs and devices in an otherwise comprehensive prescription drug plan is a violation of Title VII of the Civil Rights Act of 1964.
Citing a 2002 opinion from the state attorney general’s office, Insurance Commissioner Mike Kreidler affirmed that prescription contraceptives cannot be withheld from state-regulated plans because of an employer’s religious or conscientious objection.
But Providence challenged the mandate until 2004, according to the e-mail it sent its Eastern Washington employees Tuesday.
“As a Catholic organization, Providence Services has never endorsed contraceptive methods,” the e-mail began. “When Washington state law changed to mandate contraceptive coverage for all insured women, Catholic leaders filed an appeal based on fundamental moral disagreements, which was later refused.
“As a result, Sacred Heart removed the specific medications from the list of those excluded under the coverage of its self-insured plan in July 2004, based on the fact that these medications have multiple appropriate clinical uses,” the e-mail went on to say.
“While we communicated that changes had been made to the prescription drug list, we could not, in good conscience, do so in any way that appeared to endorse contraception. We hope that all employees understand that there was no intent to deceive anyone, only a desire to comply with a civil mandate while preserving our fidelity to Church teaching.”
The e-mail was signed by Rich Umbdenstock, of Providence Services in Seattle.
Paying out of pocket
Dr. Jim Shaw, medical director of Providence Center at Sacred Heart and the hospital’s ethicist, said that while the benefits package did not specifically state that prescription contraceptives were now covered, they were no longer listed among excluded drugs. They had been prominent on that list before.
“By removing that exception, it is not changing the position of the Catholic Church against contraception,” Shaw stressed. “They (management) weren’t aware it had caused inconvenience or frustration and now apologize for it.”
It could not be determined Wednesday how many employees had incurred out-of-pocket expenses as a result of not knowing contraceptive coverage was available.
Yasmin, an estrogen and progestin combination contraceptive pill, can cost $48 for a month’s supply. Providence employees in Spokane have a choice of Group Health or a self-insurance plan administered by a third party. Sacred Heart employees were told Tuesday they could not fill their contraception prescription at the Sacred Heart pharmacy, but could do so at a retail or Group Health pharmacy, depending on coverage.
Williams, who has worked as a nurse at Sacred Heart for 17 years, learned of the change recently when a friend was prescribed birth control pills to relieve symptoms of an ovarian cyst.
Since July 2004, she estimated, she has spent $726.95 for birth control pills when she should have spent only $126 in co-payments.
Tuesday’s apology from Providence did little to salve her indignation with her employer.
“I’m still upset that they took my money for insurance coverage and then didn’t give us coverage because they didn’t tell us we had it,” Williams said.