California Insurance Agency Penalized for Not Covering ‘Cosmetic Procedures’ for ‘Gender Transitions’

WOODLAND HILLS, Calif. — An insurance agency in California has been leveled with a $200,000 administrative penalty for declining to cover cosmetic procedures and other “gender transition”-related services for seven patients in the state who identify as transgender.

The California Department of Managed Health Care recently sent a letter to Health Net to outline its findings following an investigation in regard to the company’s policies and practices surrounding “gender reassignment” surgeries.

“Between December 2013 and February 2015, the plan and/or its delegated medical groups denied requests from seven enrollees for medical services in relation to gender reassignment on the basis that the services were not covered benefits, in violation of the Insurance Gender Nondiscrimination Act of 2006,” the department wrote.

The cited state law prohibits insurance agencies from denying benefits to patients because of their gender identity.

“As a result of the plan and/or its delegated medical groups’ denial, seven enrollees were denied health care services such as consultation, testosterone injections, gender reassignment surgery, bilateral mastectomy, and facial feminization surgery,” the letter noted.

“In three of the seven cases, the plan denied on the basis that the requested services were cosmetic in nature, and therefore not covered,” it further explained. “In two of these cases, the plan relied on a categorical limitation in the EOC (evidence of coverage) that limited covered services to the transgender surgery, and excluded all other services beyond the actual surgery.”

Health Net’s policies prohibit coverage of procedures meant to change one’s “physical characteristics” to be like those of the opposite gender.

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But regulators state that this violates state law, and has determined that Health Net must pay a $200,000 administrative penalty. The company must also provide written confirmation that it has reviewed and revised its policies to prevent any further coverage denials to those obtaining “gender transition”-related procedures. Those who were denied coverage in the past must either have their cases reevaluated and/or be paid for out-of-pocket expenses.

Health Net has agreed to comply with the requested terms.

According to the San Francisco Chronicle, the California Department of Managed Health Care has taken action against three other healthcare plans in the past in regard to their handling of those with gender dysphoria.

The Benson Commentary on the Bible says of Psalm 94:20, “Wilt Thou take part with the unrighteous powers of the world, who oppress Thy people? Wilt Thou countenance and support these tyrants in their wickedness? We know Thou wilt not; but wilt manifest Thy justice and displeasure against them.”

“A throne has fellowship with God, when it is a throne of justice, and answers the end of its being erected, for by Him kings reign. And when they reign for Him their judgments are His, and He owns them as His ministers; and whoever resist them, or rise up against them, shall receive to themselves condemnation. But when it becomes a throne of iniquity, it has no longer fellowship with God. Far be it from the just and holy God that He should be the patron of unrighteousness…”

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