[ilovetv]

What do you think, after reading this article and then the article linked on always-looming cuts to Medicare providers?

WASHINGTON -- The Centers for Medicare and Medicaid Services (CMS) said it would reconsider covering gender change surgery under Medicare for patients with gender identity disorder.

Formerly called transsexual surgery, the procedure is not currently reimbursed by Medicare, under a policy dating back to 1981. At that time, the agency determined that gender change surgery was "experimental" and therefore not eligible for coverage.

The new review was prompted by two individuals who wrote to CMS, arguing that gender identity disorder and surgical gender change treatment were now accepted in medical practice. One of the petitioners cited a 2008 American Medical Association resolution backing "public and private health insurance coverage" for treatment of gender identity disorder.

CMS's decision to reconsider coverage of surgical treatment triggers an initial 30-day public comment period, which will end April 27. In announcing the review, the agency said it was "particular interested in clinical studies and other scientific information relevant to the topic under review."

In general, CMS requires evidence that a treatment is both effective and medically necessary before it will approve Medicare coverage.

Although allowance of Medicare coverage would probably benefit few transgender individuals directly, such determinations often affect coverage policies for Medicaid and private health plans.

CMS to Review Gender Change Surgery

Medicare doctors face 29% pay cut in New Year

CNN (12/31/12)

....On Jan. 1, physicians face a 26.5% cut in reimbursement rates....

....Fed up with the uncertainty, Hoven said doctors are evaluating their practices to determine whether they can afford to stay in business, since private insurers also base their reimbursement rates on Medicare rates....

Medicare doctors face 29% pay cut in New Year - Dec. 31, 2012

[Mack184]

No under any circumstances. If somebody wants that sort of surgery, let them reach into their own pocket and pay for it. Not Medicare's money, not private insurance money, not medicaid money. NO! If they want it..they can spend their money.

[Geewiz]

My ex-spouse practices male to female reassignment surgery....gratis! No anesthesia...no instruments...just sharp teeth and an attitude. You just need to ignore the growling and massive bleeding.

The word is that the CIA is sending her on a secret mission to North Korea....that poor little dictator.

[Golfingnut]

If it is cosmetic, it should be disapproved. However, if the doctors declare it a mental disorder than cannot be corrected by medication, perhaps the surgery would be appropriate. I mean, don't we wish for everyone to enjoy a full and rich life?

[ilovetv]

After seeing this section of Centers for Medicare & Medicaid Services, indicating that Public Comments are welcome and must be submitted using their "section 508 compliant" submission window and "orange Submit button" on their site, I've now searched the site for over 30 minutes looking for a Public Comments section on this particular topic, and still haven't found one. (Maybe the timeframe for commenting has ended?)

Public Comments
Section 1862(l)(3) of the Social Security Act establishes an opportunity for the public to submit comments on proposed national coverage determinations. CMS encourages public comments and the submission of additional medical, technical, and scientific evidence, and must respond to these comments in our final determination as required by law. Public participation increases the quality of agency decision making.....

..NOTE: In accordance with HHS guidelines, CMS will only post materials that are 508 compliant. Comments submitted electronically through this website (using the orange comment button) are automatically entered into 508 compliant format. We are requesting that submitters that send comments outside of that electronic process ensure that the comments are 508 compliant...."

Public Comments - Centers for Medicare & Medicaid Services

I think contacting our congressional representatives is in order.

[ilovetv]

Originally Posted by Golfingnut

If it is cosmetic, it should be disapproved. However, if the doctors declare it a mental disorder than cannot be corrected by medication, perhaps the surgery would be appropriate. I mean, don't we wish for everyone to enjoy a full and rich life?

I read that as of 2003 the Centers for Medicare/Medicaid Services determined this, quoted below. It is definitely not cosmetic, when you see the complexity and the dangers involved in the numerous anatomical and organ system restructurings done. I'd question whether the whole of surgical techniques, medical followup and outcomes have advanced all that much in ten years:

Transsexual surgery, also known as sex reassignment surgery or intersex surgery, is the culmination of a series of procedures designed to change the anatomy of transsexuals to conform to their gender identity. Transsexuals are persons with an overwhelming desire to change anatomic sex because of their fixed conviction that they are members of the opposite sex.

For the male-to-female, transsexual surgery entails castration, penectomy and vulva-vaginal construction. Surgery for the female-to-male transsexual consists of bilateral mammectomy, hysterectomy and salpingo-oophorectomy which may be followed by phalloplasty and the insertion of testicular prostheses. Transsexual surgery for sex reassignment of transsexuals is controversial.

Because of the lack of well controlled, long term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexualism, the treatment is considered experimental. Moreover, there is a high rate of serious complications for these surgical procedures. For these reasons, transsexual surgery is not covered.

http://www.cms.gov/Regulations-and-G...03c1_part2.pdf

[Taltarzac725]

Originally Posted by Golfingnut

If it is cosmetic, it should be disapproved. However, if the doctors declare it a mental disorder than cannot be corrected by medication, perhaps the surgery would be appropriate. I mean, don't we wish for everyone to enjoy a full and rich life?

True. This seems more complicated as you suggest than some make it out to be. I agree that purely cosmetic surgery should not be approved unless perhaps we are talking about someone who has been scarred by accident, violence or whatever. Are plastic surgeries covered??

[Geewiz]

OK...I sometimes assume that folks get my mocking...

Guess what kids...this is insignificant...we have real problems....banks too big to regulate...potential wars with North Korea and Iran....a huge division in public trust of their elected leaders...

Is sexual reassignment really an issue...we waste more money on weapons systems that even generals on government-funded golf courses mock.

Imperial Rome figured out that the key to power was "Lets you and him fight." Don't be played by sideshow acts...save your indignation for those who reach deep in your pockets...not the 17 folks who might get this surgery. Really, figure out the important sentence.

[Taltarzac725]

Originally Posted by Geewiz

OK...I sometimes assume that folks get my mocking...

Guess what kids...this is insignificant...we have real problems....banks too big to regulate...potential wars with North Korea and Iran....a huge division in public trust of their elected leaders...

Is sexual reassignment really an issue...we waste more money on weapons systems that even generals on government-funded golf courses mock.

Imperial Rome figured out that the key to power was "Lets you and him fight." Don't be played by sideshow acts...save your indignation for those who reach deep in your pockets...not the 17 folks who might get this surgery. Really, figure out the important sentence.

Good point. I did enjoy your humor. This probably affects more people than you would think. I drove through Trinidad CO in 1984 or so and it seemed that this small Colorado town had a thriving industry in sex change operations. I had wondered who was paying for these operations and how. I was just travelling along a more scenic route home to Reno, Nevada than the Interstates.

[Geewiz]

Originally Posted by Taltarzac725

Good point. I did enjoy your humor. This probably affects more people than you would think. I drove through Trinidad CO in 1984 or so and it seemed that that small town had a thriving industry in sex change operations. I had wondered who was paying for these operations and how.

Granted there are more than 17 folks lined up to have their private parts reassigned...again, Voldemort (my ex-spouse) will do it for free...

Still, it's less than this..

F-22 Raptor Loses $79 Billion Advantage in Dogfights: Report - ABC News

Tax day is on the cusp!

[Taltarzac725]

Originally Posted by Geewiz

Granted there are more than 17 folks lined up to have their private parts reassigned...again, Voldemort (my ex-spouse) will do it for free...

Still, it's less than this..

F-22 Raptor Loses $79 Billion Advantage in Dogfights: Report - ABC News

Tax day is on the cusp!

You might find this of interest.

Marci Bowers - Wikipedia, the free encyclopedia

Do not remember her/him from the University of Minnesota where it looks like he/she was Student Body President of the U of MN. The U of Minnesota was extremely liberal in outlook so I am not surprised.

[Geewiz]

Originally Posted by Taltarzac725

You might find this of interest.

Marci Bowers - Wikipedia, the free encyclopedia

Do not remember her/him from the University of Minnesota where it looks like he/she was Student Body President of the U of MN. The U of Minnesota was extremely liberal in outlook so I am not surprised.

Beat this...

Divorce

[Moderator]

Please address the topic and refrain from political and off topic comments.

Thanks.

[Geewiz]

BTW - speaking of U of M...

I had 2 major profs in graduate school....one was the historian for St. Augustine...but, the other went to U of M and his roommate was Bob (Dylan) Zimmerman....

He told me that Bob was a jerk but was always able to isolate the important sentence.

We can joke about silly stuff...but, "the importance sentence" is so named 'cause it is important.

[Geewiz]

And my dear mod...this addresses the ludicrous point of the topic without being overtly partisan.