On June 2, the Centers for Medicare & Medicaid Services
(CMS) published a proposed decision memo on gender dysphoria and gender
reassignment surgery which continues the existing policy of
allowing local Medicare contractors to determine coverage on an
individual basis.
CMS declined to issue a national coverage determination at this
time because its review of the clinical evidence for gender
reassignment surgery was inconclusive for the Medicare population,
due to the limited number of clinical studies specifically about
Medicare beneficiaries' health outcomes for gender reassignment
surgery and small sample sizes. CMS noted that additional clinical
studies are necessary and is requesting public comments,
particularly on any new evidence that was not reviewed. Comments
can be submitted to CMS here.
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