The U.S. Department of Health and Human Services Departmental Appeals Board ( DAB ) announced it has overturned the Medicare policy of categorically excluding coverage for gender transition—related surgical procedures that are medically necessary for many transgender people, according to ThinkProgress.org .
The DAB, an independent administrative entity within HHS, ruled that the ban is unreasonable and contrary to contemporary science and medical standards of care.
The lifting of the coverage exclusion means that transgender Medicare beneficiaries will now be able to seek individualized review of the medical necessity of the specific procedure they need, just like anyone seeking coverage for any other medical treatment.
"As HHS appropriately points out, excluding coverage for transition-related surgery is unreasonable as viewed by the standards of the medical profession todayincomplete, unfair, and obsolete," said SPARTA policy director, former Army Captain Allyson Robinson, in a statement. "The application of scientifically proven, internationally recognized standards of care to recipients of Medicare is a step in the right direction."