The Centers for Medicare & Medicaid Services (CMS) on Aug. 13 published a final rule that prohibits states from using federal Medicaid funding to cover “sex-rejecting procedures” (SRPs), also referred to as gender transition care.
The rule prohibits state Medicaid programs from paying for puberty blockers, hormone therapy, and surgeries intended for gender transition care for children under 18 in Medicaid and under 19 in the Children’s Health Insurance Program. CMS claims this policy change is in the best interest of beneficiaries and to ensure payments are consistent with “quality of care.”
For beneficiaries receiving hormone therapy when the rule takes effect, states can continue receiving federal matching funds for up to six months to allow them to taper off the medication.
The final rule goes into effect Oct. 13.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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