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Ban Lifted On Medicare Coverage For Sex Reassignment

Francesca Bessey |
May 30, 2014 | 2:15 p.m. PDT

Executive Producer

Transgender rights advocates struck gold today when the Departmental Appeals Board of the Department of Health and Human Services (HHS) released a ruling concluding a ban on Medicare's coverage of sex reassignment surgery is pretty much bogus.

Sex reassignment surgery, banned by HHS in 1981 for its so-called "experimental" nature and risk of "serious complications, is today considered a safe and acceptable procedure by most professional medical organizations.

SEE ALSO: Trans Actress Laverne Cox Graces Cover Of Time Magazine

"Even assuming the [National Coverage Determination]'s exclusiong of coverage at the time the NCO was adopted was reasonable, that coverage exclusion is no longer reasonable," the ruling reads. "This record includes expert medical testimony and studies published in the years after the publication of the NCO."

According to leaders of the ACLU, Gay & Lesbian Advocates & Defenders and the National Center for Lesbian Rights, the groups who fought for the change, the decision "removes a threshold barrier to coverage for medical care for transgender people under Medicare." The change may also help drive more private insurers to offer similar coverage for sex reassignment surgery and care.

SEE ALSO: After Dr. V: Transgender Is No Con

Advocates, however, have noted that the lifting of the ban does not automatically mean that Medicare will start covering the surgery, only that it will no longer be prevented from doing so when claims are made. It also does not address other medical exclusions for transgender Americans.


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Reach Executive Producer Francesca Bessey here; follow her here.



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