December 17, 2014

Governor Cuomo Announces Proposed Regulations to Provide Medicaid Coverage for Transgender Care and Services

TOP Governor Cuomo Announces Proposed Regulations...

Governor Andrew M. Cuomo today announced new regulations to include transgender health care services under New York State’s Medicaid program. The proposed regulations provide treatment for hormone therapy and gender reassignment surgery.

“New York has always been a progressive leader and ensuring that all New Yorkers – regardless of gender identity – are treated fairly will continue this legacy,” Governor Cuomo said. “This new regulation will guarantee transgender New Yorkers access to Medicaid-funded care, which is critical to safeguarding the principle of equal treatment. I am proud that the State is taking this step and continuing to lead the fight on transgender rights.”

Under the proposed regulations, hormone therapy and gender reassignment surgery would be covered for persons who have referrals from medical professionals. Surgery would be covered for individuals who are a minimum age of 18 or 21 years old, depending on specific circumstances.

Referring medical professionals will have to document that a patient has persistent gender dysphoria, has received appropriate hormone therapy a minimum of one year, has lived a minimum of one year in the gender role consistent with the person’s gender identity and has received mental health counseling.

“Ensuring the equal treatment of all New Yorkers has been and continues to be a central focus of Governor Cuomo’s administration,” said Alphonso B. David, Deputy Secretary and Counsel for Civil Rights. “As the new regulation makes clear, transgender New Yorkers are no exception to this theme. With this regulatory change, these New Yorkers will be treated equally with respect to access to Medicaid-funded medical care.”

“Medical evidence supports gender reassignment surgery as a safe and effective treatment for gender dysphoria,” said acting Health Commissioner Dr. Howard Zucker. “This modernization of our Medicaid payment coverage brings New York State in alignment with Medicare policy and improves the quality of life for New Yorkers whose gender identity is not the gender with which they were born.”

New York will join California, Massachusetts, Oregon, Vermont, and Washington D.C., which cover transgender health care through their Medicaid programs. In May, the federal government also ended its decades-long exclusion of coverage for certain services related to gender transition under Medicare.

The introduction of this Medicaid regulation follows last week’s announcement that New York State law requires private health insurance companies to cover transgender health care on the same terms as other care. It also follows New York State’s revisions to its birth certificate policy for transgender people. Pursuant to that policy, corrected birth certificates are issued when a licensed medical provider states that a transgender individual has received appropriate clinical treatment.

The public will have 45 days to comment on the proposed regulation. 

Contact the Governor's Press Office
Contact the Governor's Press Office

NYC Press Office:  212.681.4640

Albany Press Office:  518.474.8418