In either case it's considered a contraceptive for billing purposes and by insurance.
I don't think this is true, but I could be wrong -- cite?
It's coded for Medicare/Medicaid Billing Purposes. Essentially everything in medicine is sold under designations from Medicare/Medicaid, because of the reimbursement requirements (what I mean is it's easier to label everything the same because of how complicated billing is in medicine). It is the pill they are billing for, not the use, and they are typically designated as 'Oral Contraceptives' or 'Oral Pill for Birth Control' or something along those lines.
Although, since Medicaid varies by state, the designations may be different in other places.
But this is largely from my healthcare economics education and my Fiance who is currently on clinical rotations for her DO. I don't have a specific reference off-hand.
And they don't need to hire "disreputable" doctors. They just need to say they have bad cramps.
ok, so you can lie to your doctor to, so what? Seriously, how is this line of discussion relevant?
It's not even lying to the doctor. Look at how ADD medication is given out. "I have cramps" is about all a girl needs to say and any doctor will prescribe the medication.
If this drug is acceptable as a means to regulate periods, then it's no different than across the board acceptable.
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"[Screw] you and the green you ramped in on." - My EDH battle cry. If I had one. Which I don't.
If the issue at hand is that certain religious groups object to contraceptives, wouldn't they object to them regardless of whether it's preventing pregnancy as the primary use or as a side effect?
Either way, their moral objection is present. If that's what causes the issue, then it doesn't matter what it gets prescribed for.
It's coded for Medicare/Medicaid Billing Purposes. Essentially everything in medicine is sold under designations from Medicare/Medicaid, because of the reimbursement requirements (what I mean is it's easier to label everything the same because of how complicated billing is in medicine). It is the pill they are billing for, not the use, and they are typically designated as 'Oral Contraceptives' or 'Oral Pill for Birth Control' or something along those lines.
Although, since Medicaid varies by state, the designations may be different in other places.
But this is largely from my healthcare economics education and my Fiance who is currently on clinical rotations for her DO. I don't have a specific reference off-hand.
True, it is the pill they are billing for, not the use -- but the use is still relevant information and can be included. I am sure that insurance plans cover some uses of certain prescription pills and not others. It's not so hard to implement a similar scheme here. In fact, I would wager most plans that currently (or previously rather) did not cover contraceptives still covered the same pill for alternative uses such as hormone therapy.
If the issue at hand is that certain religious groups object to contraceptives, wouldn't they object to them regardless of whether it's preventing pregnancy as the primary use or as a side effect?
Either way, their moral objection is present. If that's what causes the issue, then it doesn't matter what it gets prescribed for.
That may apply to some who object, certainly, but as the article notes, there are also those who reject that idea. It's not the court's job to decide that one religious view is correct and the other is incorrect - we have to treat both on equal footing.
If employment wasnt tied to healthcare this wouldnt be an issue. The computer scientist in me is thinking that these items are becoming way too highly coupled. The reason businesses started offering health benefits through work was because large businesses could get a discount on coverage by being able to promise a large number of clients to the insurance company. This allowed the business to offer an employee a value for their work greater than what the company actually has to pay for it. While this may still hold true for IBM... how large of an employee pool must a business have for this to really make sense? If a company only has 70 employees how good of a deal will an insurance company give them on rates? Do insurance companies even provide this still? Is it really better to force everyone to provide the same benefit or would it be better to give alternative which then would devalue the benefit and force employers to offer different benefits.
I bring this up as someone who is young and married where both of us work for companies that provide very cheap insurance options. This means that for both of us, whether or not we enroll in coverage a portion of our "pay" is the ability to enroll into those benefits. It would be more beneficial if insurance was affordable outside employment and both of our companies raised our pay instead of offering insurance options.
I dont think government should have any hand in what businesses have to offer it's employees in terms of benefits.
If it's ok to prescribe "hormone therapy" to make periods lighter and every other good thing this does that's not contraceptive, there will be no way to stop having "hormone therapy" prescribed as contraceptives.
Perscriptions state what they are for. It's not hard to say "this drug is covered when prescribed for X, and not covered when prescribed for Y."
You would be very surprised at some of the insurance company formularies.
I was prescribed a topical drug designed to hinder the growth of some dermal cysts because I had had an adverse reaction to a similar oral drug.
Because the primary purpose of the drug was advanced acne treatment the insurance company only covered it up to age 24 since apparently people over 24 don't have a medical need for acne treatments.
At $60/oz I wasn't interested in any long term regimens with this particular product.
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Out of the blackness and stench of the engulfing swamp emerged a shimmering figure. Only the splattered armor and ichor-stained sword hinted at the unfathomable evil the knight had just laid waste.
BLatch: Its quite possible things have changed in 25 years but my first job was going through codes for a doctors office, and back then all that mattered was the med for what it got coded under - application was moot.
That may apply to some who object, certainly, but as the article notes, there are also those who reject that idea. It's not the court's job to decide that one religious view is correct and the other is incorrect - we have to treat both on equal footing.
That isn't exactly relevant to the discussion now is it? The fact that some people don't agree with double effect doesn't negate that some people do. Which means that, yes, there are people who would object to the birth control pill prescribed on the basis of contraception that would not on the basis of some other reason.
I think maybe you forgot what you said that caused me to link to double effect...
That isn't exactly relevant to the discussion now is it? The fact that some people don't agree with double effect doesn't negate that some people do. Which means that, yes, there are people who would object to the birth control pill prescribed on the basis of contraception that would not on the basis of some other reason.
I think maybe you forgot what you said that caused me to link to double effect...
It seems perfectly relevant to me. The reason the mandate is claimed to be constitutionally problematic is that some businesses apparently object to buying insurance which covers contraceptives. People raised a counter-point asking about use of the same medicine for non-contraceptive purposes, and you claimed that, because contraception is only a side-effect in those cases, it doesn't present the same issues.
My response to that is that there are people who object to contraceptive drugs whether the contraception is what it's being prescribed for, or whether it's a side-effect. If we accept that people having this sort of objections raises a constitutional problem, then it is certainly also raised for non-contraceptive uses.
Whether or not some sects object only to intentional contraceptive use is what's irrelevant. The important point is that some also object to contraception-as-side-effect.
In either case it's considered a contraceptive for billing purposes and by insurance.
I don't think this is true, but I could be wrong -- cite?
ance who is currently on clinical rotations for her DO. I don't have a specific reference off-hand.
<- Works for a pharmaceutical company
It's coded however the doctor who prescribed it codes it.
And bLatch is correct, different codes are handled differently per the formulary requirement the payer has for the drug.
It's not even lying to the doctor. Look at how ADD medication is given out. "I have cramps" is about all a girl needs to say and any doctor will prescribe the medication.
If this drug is acceptable as a means to regulate periods, then it's no different than across the board acceptable.
If a girl came in and said "I have cramps" she would get a prescription submitted with a code for a diagnosis of "menstrual cramps". If the ADD medication is not on formulary for menstrual cramps, the insurance company will deny the claim and she will need to pay full price for the product
Remember, we're not talking about access here. An insurance company cannot deny you access to any medication you have a prescription for. They can refuse to pay for it, but you can still pay for it yourself.
True, it is the pill they are billing for, not the use -- but the use is still relevant information and can be included.
It is coded for the diagnosis. As many oxycontin addicts will tell you, "diagnosis" does not always equal use.
If employment wasnt tied to healthcare this wouldnt be an issue.
And if wishes were tree's....
Like it or not our political system is not able to create a sensible national health care system. It is politically beyond us.
You would be very surprised at some of the insurance company formularies.
I was prescribed a topical drug designed to hinder the growth of some dermal cysts because I had had an adverse reaction to a similar oral drug.
Because the primary purpose of the drug was advanced acne treatment the insurance company only covered it up to age 24 since apparently people over 24 don't have a medical need for acne treatments.
At $60/oz I wasn't interested in any long term regimens with this particular product.
In those cases you should be able to contact the prescribing physician and they can explain the correct coding to the insurance company, but if it is an off label usage or not on the insurance companies formulary, they aren't going to pay for it.
Its quite possible things have changed in 25 years but my first job was going through codes for a doctors office, and back then all that mattered was the med for what it got coded under - application was moot.
They code what it is being used for (the diagnosis)
My biggest problem is if a company is owned by a Jehovah's Witness or a Christian Scientist but the company is not a subsidiary of their respective churches, should they be allowed to not cover blood transfusions or any medical expenses at all?
Or Happyologists (if you're familiar with TV Tropes) and psych meds?
Hey, all modern medicine depends on natural selection as a theory to even make sense. Why don't we just say Evangelicals can go back to bloodletting and imbibing mercury and arsenic?
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Card advantage is not the same thing as card draw. Something for 2B cannot be strictly worse than something for BBB or 3BB. If you're taking out Swords to Plowshares for Plummet, you're a fool. Stop doing these things!
Before I get into this I'd like to point out that I think Hobby Lobby has no buisness dicating how employees spend their benefits. They are not morally responsible for what other people do.
"Congress has given a statutory entitlement and that entitlement is to women and includes contraceptive coverage," said Justice Elena Kagan. "And when the employer says, no, I don't want to give that, that woman is quite directly, quite tangibly harmed."
I think Kagen does not under stand what the issue is...its not about if the woman is harmed...its more about if congress have the right to force a company to give an entitlement that conflicts with their personal religious beliefs....who cares what entitlment congress has given? Even is you bought into this equivocation, what about the harm to the company?
I'll never claim to be as educated or expereiced as a supreme court justice but how can this justice make such a stupid statement?
I see where she got that line of thinking from considering this from the solictor general:
"In the entire history of this country, there is not a single case in which a for-profit corporation was granted an exemption" on religious liberty grounds, when that would harm the rights of others, he added".
In my opinion it is stupid when we think contraception/birth control from an employer insurance is a right. The employee can still buy contraception and get birth control wheather or not the insurance pays for it or not.
"Congress has given a statutory entitlement and that entitlement is to women and includes contraceptive coverage," said Justice Elena Kagan. "And when the employer says, no, I don't want to give that, that woman is quite directly, quite tangibly harmed."
I think Kagen does not under stand what the issue is...its not about if the woman is harmed...its more about if congress have the right to force a company to give an entitlement that conflicts with their personal religious beliefs....who cares what entitlment congress has given? Even is you bought into this equivocation, what about the harm to the company?
If what she said is true, and congress has created a statutory entitlement to contraceptive coverage, then there is no question that denying the coverage provides a legal harm to the woman.
Its a very straightforward issue.
The real question in the case is whether corporations have a right to practice a religion.
If what she said is true, and congress has created a statutory entitlement to contraceptive coverage, then there is no question that denying the coverage provides a legal harm to the woman.
The issue is not wheather it brings harm to the woman. The issue is does this harm to the employer. The employee is not the one suing. Having this coverage manadate harms the company. The question is not that it harms but how it harms.
EDIT: there are plenty of companies that practice religion and received an exemption.
The issue is not wheather it brings harm to the woman. The issue is does this harm to the employer. The employee is not the one suing. Having this coverage manadate harms the company. The question is not that it harms but how it harms.
As is the case in pretty much every legal proceeding ever, in the history of all mankind ever, there is more than one relevant issue. Whether there is a legal harm to the employee by the employer is relevant to the issues in the case. That makes it a relevant question for her to ask.
But more on point, you were blasting her for saying something dumb, when what she said made legal sense and was relevant.
The issue is not wheather it brings harm to the woman. The issue is does this harm to the employer. The employee is not the one suing. Having this coverage manadate harms the company. The question is not that it harms but how it harms.
As is the case in pretty much every legal proceeding ever, in the history of all mankind ever, there is more than one relevant issue. Whether there is a legal harm to the employee by the employer is relevant to the issues in the case. That makes it a relevant question for her to ask.
But more on point, you were blasting her for saying something dumb, when what she said made legal sense and was relevant.
No, it is not. It's irrelevant. The issue before the court is clearly about the mandate placed upon the employer and if that harm violates that employers rights. There is no reason to consider the rights of the employee. If it harms the rights of the employer that does not somehow make it valid since it would violate the right of the employee. This is an example of a liberal trying to shift the goalpost. She said something dumb and irrelevant when dicussing the rights of the other people who were not in her court and had nothing to do with issue about the employers rights that are in question.
The issue is not wheather it brings harm to the woman. The issue is does this harm to the employer. The employee is not the one suing. Having this coverage manadate harms the company. The question is not that it harms but how it harms.
As is the case in pretty much every legal proceeding ever, in the history of all mankind ever, there is more than one relevant issue. Whether there is a legal harm to the employee by the employer is relevant to the issues in the case. That makes it a relevant question for her to ask.
But more on point, you were blasting her for saying something dumb, when what she said made legal sense and was relevant.
No, it is not. It's irrelevant. The issue before the court is clearly about the mandate placed upon the employer and if that harm violates that employers rights. There is no reason to consider the rights of the employee. If it harms the rights of the employer that does not somehow make it valid since it would violate the right of the employee. This is an example of a liberal trying to shift the goalpost. She said something dumb and irrelevant when dicussing the rights of the other people who were not in her court and had nothing to do with issue about the employers rights that are in question.
I'm not sure how to refer to that other than to defer to your superior Internet blog based legal knowledge. Clearly my Jurus Doctor degree, and my State Bar of Michigan membership pale in comparison to information you gleaned reading right wing blogs.
Not when they show up on the bill.
And they don't need to hire "disreputable" doctors. They just need to say they have bad cramps.
Pristaxcontrombmodruu!
Maybe the bill *you* see. I can assure you the insurance company sees more than just what drug was prescribed before they pay out.
ok, so you can lie to your doctor to, so what? Seriously, how is this line of discussion relevant?
It's coded for Medicare/Medicaid Billing Purposes. Essentially everything in medicine is sold under designations from Medicare/Medicaid, because of the reimbursement requirements (what I mean is it's easier to label everything the same because of how complicated billing is in medicine). It is the pill they are billing for, not the use, and they are typically designated as 'Oral Contraceptives' or 'Oral Pill for Birth Control' or something along those lines.
Although, since Medicaid varies by state, the designations may be different in other places.
But this is largely from my healthcare economics education and my Fiance who is currently on clinical rotations for her DO. I don't have a specific reference off-hand.
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The relevancy is that someone made the claim that not covering contraceptives would prohibit the alternative uses of those drugs as well.
My contention is that no, it wouldn't. Because the alternative uses could still be covered without covering prescriptions for contraception.
Care to cite that? Evidence in the thread says differently.
It's not even lying to the doctor. Look at how ADD medication is given out. "I have cramps" is about all a girl needs to say and any doctor will prescribe the medication.
If this drug is acceptable as a means to regulate periods, then it's no different than across the board acceptable.
Pristaxcontrombmodruu!
Either way, their moral objection is present. If that's what causes the issue, then it doesn't matter what it gets prescribed for.
True, it is the pill they are billing for, not the use -- but the use is still relevant information and can be included. I am sure that insurance plans cover some uses of certain prescription pills and not others. It's not so hard to implement a similar scheme here. In fact, I would wager most plans that currently (or previously rather) did not cover contraceptives still covered the same pill for alternative uses such as hormone therapy.
No, because of the principle of double effect. (http://en.wikipedia.org/wiki/Double_effect )
I will look for it this evening... don't have time at work right now. But, its a fair request.
That may apply to some who object, certainly, but as the article notes, there are also those who reject that idea. It's not the court's job to decide that one religious view is correct and the other is incorrect - we have to treat both on equal footing.
I bring this up as someone who is young and married where both of us work for companies that provide very cheap insurance options. This means that for both of us, whether or not we enroll in coverage a portion of our "pay" is the ability to enroll into those benefits. It would be more beneficial if insurance was affordable outside employment and both of our companies raised our pay instead of offering insurance options.
I dont think government should have any hand in what businesses have to offer it's employees in terms of benefits.
You would be very surprised at some of the insurance company formularies.
I was prescribed a topical drug designed to hinder the growth of some dermal cysts because I had had an adverse reaction to a similar oral drug.
Because the primary purpose of the drug was advanced acne treatment the insurance company only covered it up to age 24 since apparently people over 24 don't have a medical need for acne treatments.
At $60/oz I wasn't interested in any long term regimens with this particular product.
Re: People misusing the term Vanilla to describe a flying, unleash (sometimes trample) critter.
That isn't exactly relevant to the discussion now is it? The fact that some people don't agree with double effect doesn't negate that some people do. Which means that, yes, there are people who would object to the birth control pill prescribed on the basis of contraception that would not on the basis of some other reason.
I think maybe you forgot what you said that caused me to link to double effect...
It seems perfectly relevant to me. The reason the mandate is claimed to be constitutionally problematic is that some businesses apparently object to buying insurance which covers contraceptives. People raised a counter-point asking about use of the same medicine for non-contraceptive purposes, and you claimed that, because contraception is only a side-effect in those cases, it doesn't present the same issues.
My response to that is that there are people who object to contraceptive drugs whether the contraception is what it's being prescribed for, or whether it's a side-effect. If we accept that people having this sort of objections raises a constitutional problem, then it is certainly also raised for non-contraceptive uses.
Whether or not some sects object only to intentional contraceptive use is what's irrelevant. The important point is that some also object to contraception-as-side-effect.
<- Works for a pharmaceutical company
It's coded however the doctor who prescribed it codes it.
And bLatch is correct, different codes are handled differently per the formulary requirement the payer has for the drug.
If a girl came in and said "I have cramps" she would get a prescription submitted with a code for a diagnosis of "menstrual cramps". If the ADD medication is not on formulary for menstrual cramps, the insurance company will deny the claim and she will need to pay full price for the product
Remember, we're not talking about access here. An insurance company cannot deny you access to any medication you have a prescription for. They can refuse to pay for it, but you can still pay for it yourself.
It is coded for the diagnosis. As many oxycontin addicts will tell you, "diagnosis" does not always equal use.
And if wishes were tree's....
Like it or not our political system is not able to create a sensible national health care system. It is politically beyond us.
In those cases you should be able to contact the prescribing physician and they can explain the correct coding to the insurance company, but if it is an off label usage or not on the insurance companies formulary, they aren't going to pay for it.
They code what it is being used for (the diagnosis)
Or Happyologists (if you're familiar with TV Tropes) and psych meds?
Hey, all modern medicine depends on natural selection as a theory to even make sense. Why don't we just say Evangelicals can go back to bloodletting and imbibing mercury and arsenic?
On phasing:
FYI
Before I get into this I'd like to point out that I think Hobby Lobby has no buisness dicating how employees spend their benefits. They are not morally responsible for what other people do.
I think Kagen does not under stand what the issue is...its not about if the woman is harmed...its more about if congress have the right to force a company to give an entitlement that conflicts with their personal religious beliefs....who cares what entitlment congress has given? Even is you bought into this equivocation, what about the harm to the company?
I'll never claim to be as educated or expereiced as a supreme court justice but how can this justice make such a stupid statement?
I see where she got that line of thinking from considering this from the solictor general:
In my opinion it is stupid when we think contraception/birth control from an employer insurance is a right. The employee can still buy contraception and get birth control wheather or not the insurance pays for it or not.
calling liberals loons=not okay
The standard to which the forum moderators apply the rules here.
If what she said is true, and congress has created a statutory entitlement to contraceptive coverage, then there is no question that denying the coverage provides a legal harm to the woman.
Its a very straightforward issue.
The real question in the case is whether corporations have a right to practice a religion.
The issue is not wheather it brings harm to the woman. The issue is does this harm to the employer. The employee is not the one suing. Having this coverage manadate harms the company. The question is not that it harms but how it harms.
EDIT: there are plenty of companies that practice religion and received an exemption.
calling liberals loons=not okay
The standard to which the forum moderators apply the rules here.
As is the case in pretty much every legal proceeding ever, in the history of all mankind ever, there is more than one relevant issue. Whether there is a legal harm to the employee by the employer is relevant to the issues in the case. That makes it a relevant question for her to ask.
But more on point, you were blasting her for saying something dumb, when what she said made legal sense and was relevant.
No, it is not. It's irrelevant. The issue before the court is clearly about the mandate placed upon the employer and if that harm violates that employers rights. There is no reason to consider the rights of the employee. If it harms the rights of the employer that does not somehow make it valid since it would violate the right of the employee. This is an example of a liberal trying to shift the goalpost. She said something dumb and irrelevant when dicussing the rights of the other people who were not in her court and had nothing to do with issue about the employers rights that are in question.
calling liberals loons=not okay
The standard to which the forum moderators apply the rules here.
"I get pregnant when a guy ejaculates inside me" isn't a medical condition that health insurance can cover.
Modern: U M'Olk; B Goodstuff
I'm not sure how to refer to that other than to defer to your superior Internet blog based legal knowledge. Clearly my Jurus Doctor degree, and my State Bar of Michigan membership pale in comparison to information you gleaned reading right wing blogs.
I bow to your superior credentials good sir.
Wait, what? What are you trying to say here?
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