By: Health Insurance
Submitted: 2009-09-21 11:20:43 | Word Count: 613
The procedure has not been widely available in Northern Kentucky since St. Elizabeth Medical Center bought St. Luke Hospitals in late 2008. St. Luke offered those services before the merger, but has not since because St. Elizabeth is a Catholic hospital.
The Health Department has agreed to a preliminary contract with the hospitals and doesn't know when the final deal will be complete. When it takes effect, Medicaid funds can be transferred to those two hospitals for the tubal ligation. Normally Medicaid funds cannot be used in another state.
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"Under our (federal) Title 10 contract, the services have to be provided somehow," said Emily Gresham Wherle, spokeswoman at the Health Department. "We have to make arrangements for those services."
The brouhaha over women's reproductive services is a consequence of the hospital merger, which established St. Elizabeth with a near-monopoly in Northern Kentucky. Women's advocates and the Kentucky chapter of the American Civil Liberties Union have complained bitterly that St. Elizabeth stopped offering services important to Northern Kentucky women.
Those include tubal ligations and IUD insertions, but not abortions.
Northern Kentucky women have been sterilized for years through tubal ligations at St. Luke. Since women with health insurance can cross into Ohio and get the procedure at a Cincinnati hospital, the impact of the merger has fallen mainly on low-income women, some without insurance and some reliant on Medicaid.
The Northern Kentucky Health Department is negotiating deals with Christ Hospital in Cincinnati and Georgetown Hospital in Scott County so low-income women can use Medicaid funds to have tubal ligations there.
Last week the ACLU asked the Kentucky Cabinet for Health and Family Services to hold a hearing on whether it should force the Community Foundation of Northern Kentucky, formerly the St. Luke Foundation, to offer these services.
The foundation has hired a nurse-advocate that has helped more than 200 women find access to reproductive services in Cincinnati or elsewhere. It says it doesn't have access to enough money or enough doctors to build a free-standing center.
In its complaint with state regulators, the ACLU filed on behalf of Candice Rich of Newport, who says she was told she could have her tubal ligation at the same time as a cesarean section, but then was told in February that she could not do the second operation at St. Luke in Fort Thomas.
Her insurance would not cover the procedure at Christ Hospital because she had not been told she needed to complete an informed consent form 30 days in advance, Rich said in an affidavit filed with the complaint. So her family was forced to pay $1,700 to have the tubal at Christ Hospital.
"I was only able to receive the care I needed after finding a new obstetrician at the last minute, going to an out-of-state hospital and because I had a family member able and willing to pay the out-of-pocket costs on a moment's notice," Rich said in the affidavit provided by the ACLU.
"I believe tubal ligations and other basic reproductive health services should be availabl
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