Florida fines Medicaid providers for using tax dollars to cover transgender treatments for minors.
Florida Fines Medicaid Insurers for Violating Transgender Treatment Rule
Florida has taken a groundbreaking step by fining five Medicaid healthcare insurers for violating the state’s rule against using taxpayer funds to provide transgender treatments. This is the first time any state has taken action against gender transition coverage.
“These plans recklessly continued to cover these services with permanent, harmful effects, after the rule was adopted,” said Jason Weida, Secretary of the Agency for Healthcare Administration.
Among the procedures covered by one of the plans was a double mastectomy on a 16-year-old girl. The other plans paid for puberty blockers and cross-sex hormones for minors. Florida health officials sent out letters informing the providers of the fines for their violation.
Rule Upheld Despite Recent Federal Judge Ruling
Although a federal judge recently blocked a new law in Florida that banned transgender surgeries and medications for children, a rule from the Agency for Health Care Administration still required Medicaid plan providers to deny coverage for such treatments.
According to the agency, the rule went into effect last August after a thorough review of medical literature on treatments for gender dysphoria in children. It was determined that these treatments are not medically necessary. However, the five providers covered the trans treatments in violation of the rule, which were discovered during a routine audit of the Medicaid system.
Possible Political Motivation
Typically, Medicaid rule violations occur when providers refuse to pay for covered treatments. The fact that these providers paid for procedures and medications that had been banned raises questions about potential political motivations. While Jason Weida does not want to speculate on their reasons, he stated that they will be on notice now and that his office will consider more severe penalties for any future violations.
Penalties and Sanctions
Simply Healthcare, the provider that covered the mastectomy, is facing a $30,000 penalty and will be sanctioned. The other providers will also face fines, although the exact amounts have not been specified. The non-willful sanction is the more serious penalty, as it negatively impacts a provider’s record and must be disclosed when competing for contracts. Sanctioned providers are less likely to be awarded state contracts for 10 years until the sanction expires. Simply Health has already replaced the team responsible for approving the mastectomy coverage.
Ethics and Child Protection
Jason Weida expressed gratitude to Governor Ron DeSantis for empowering his office to issue the rule blocking public money from funding transgender surgeries. He emphasized that this issue is not about politics but about ethics and the protection of children.
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“We take this issue really seriously,” he said. “We think that the protection of children is one of the most core functions of government here in Florida, and we’re going to do everything we can to protect children from these surgeries, which are really mutilating children across the country.”
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