Medi-Cal Announces New Benefit for California's Neediest

Bay Area GYN Praises Coverage for Non-Surgical Contraception Procedure

Medi-Cal, the provider of insurance coverage for California's low income population, announced last Friday that effective immediately, it will provide full coverage for in-office hysteroscopic sterilization. The revolutionary medical procedure provides the State's neediest women with an alternative to traditional surgical treatments for sterilization. Seth A. Stabinsky, M.D., FACOG, Medical Director of EASy Gyn Clinical & Research Centers of North America, Inc. based in San Jose, CA, commended Medi-Cal's announcement. Stabinsky's practice treats women from all socioeconomic backgrounds and will now be able to offer this breakthrough treatment to the many Medi-Cal recipients who reside closest to his practice in East San Jose.

"Besides teenagers, ethnic women in their late thirties and early forties are most likely to experience unplanned pregnancy," said Dr. Stabinsky. "For every public dollar spent on pregnancy prevention, three dollars are saved in prenatal and neonatal care. We cannot afford to put obstacles in front of women who desire to permanently control their family size, be they rich or poor."

Hysteroscopic sterilization utilizes tiny cameras, inserted through the vagina, to deliver an implant into each fallopian tube. The Essure® implants seal the fallopian tubes over a three-month period, followed by an X-Ray dye study to confirm closure. Thanks to Medi-Cal's decision, the less painful, scar-free alternative is now available to California's neediest women, allowing them to resume normal activities within a day. The FDA approved the first incisionless sterilization procedure in 2001. Another device, Adiana®, is currently undergoing final FDA review. Until now, the procedure has been available only to women whose insurance companies covered the procedure, or those who had the means to pay out-of-pocket.

In 2005, California public funds paid for almost 24,000 births and over 7,500 abortions in women aged 35-44. The Guttmacher Institute estimates that of six million annual U.S. pregnancies, half are unintended, 1.3 million end in abortion, and 17% of these occur in California. Many women who ultimately choose to abort may have preferred prior sterilization if the procedure was covered by insurance, office-based, and did not require general anesthesia, multiple incisions and a 3-4 day recovery.

According to Dr. Stabinsky, who completed a fellowship in endoscopic gynecology at Stanford University, and was recently the medical supervisor for a clinical trial of over 600 women who underwent hysteroscopic sterilization, "The most exciting aspect of the new endometrial ablation technology is that in skilled hands, it is quickly and easily performed in the office using minimal sedation and local anesthesia." Stabinsky currently treats women at the Endometrial Ablation & Sterilization Center of San Jose, Inc. (A CA Professional Corporation) where he offers the non-surgical procedure.

The Family PACT program of the State Office of Family Planning, which provides reproductive healthcare to the majority of California's low-income families, will not yet cover the Essure device due to budget constraints. "This is extremely disappointing considering the large number of women for whom FPACT provides contraceptive services," said Dr. Stabinsky. "Hysteroscopic sterilization would save the State a tremendous amount of money. I hope they can overcome their budget constraints quickly, finding a way to follow Medi-Cal's courageous lead."

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