US Federal Register - CMS Rules · August 13, 2026

Medicaid Program; Prohibition on Federal Medicaid and Children's Health Insurance Program Funding for Sex-Rejecting Procedures Furnished to Children

Federal Medicaid and CHIP funding prohibited for sex-rejecting procedures in individuals under 18 (Medicaid) and 19 (CHIP); existing hormone therapy may continue for 6 months.

High obligation Framework Health System & Payment Public Health United States Provider paymentReimbursement

This final rule requires that a State Medicaid plan must provide that the Medicaid agency will not make payment under the plan for sex-rejecting procedures for children under 18, and prohibits the use of Federal Medicaid dollars to fund sex-rejecting procedures for individuals under the age of 18. In addition, this final rule requires that a separate State Children's Health Insurance Program (CHIP) plan must provide that the CHIP agency will not make payment under the plan for sex-rejecting procedures for children under 19, and prohibits the use of Federal CHIP dollars to fund sex-rejecting procedures for individuals under the age of 19. For Medicaid and CHIP beneficiaries who are actively receiving cross-sex hormone therapy, State Medicaid and CHIP agencies may continue to claim Federal Financial Participation for those hormone therapy medications for a period of up to 6 months from the effective date of this final rule.

Read the official source ↗

Published by US Federal Register - CMS Rules. HealthSignal links to the original document; the summary above is extracted from the source text.