CMS Deputy Chief Operating Officer John Czajkowski | cms.gov/about-cms/leadership/deputy-chief-operating-officer
The Centers for Medicare & Medicaid Services (CMS) has initiated an oversight program targeting hospitals that perform pediatric sex trait modification procedures. This move follows concerns about adherence to quality standards and the financial aspects of these procedures.
"These are irreversible, high-risk procedures being conducted on vulnerable children, often at taxpayer expense," said CMS Administrator Dr. Mehmet Oz. "Hospitals accepting federal funds are expected to meet rigorous quality standards and uphold the highest level of stewardship when it comes to public resources—we will not turn a blind eye to procedures that lack a solid foundation of evidence and may result in lifelong harm."
CMS has highlighted the absence of reliable clinical evidence supporting the safety and effectiveness of puberty blockers, cross-sex hormones, and sex trait modification surgeries for minors. These interventions raise significant issues regarding informed consent protocols, potential adverse outcomes, and financial incentives, with many being reimbursed by federal healthcare programs.
The letter from CMS addresses several key areas: how informed consent is obtained for pediatric patients and whether parental involvement is required; any planned updates to clinical guidelines based on comprehensive scientific research reviews; documentation requirements for adverse outcomes, including cases involving regret or de-transition; and provider financials, such as billing codes used for sex trait modifications, facility and provider-level revenue, profits, and projected revenue for these services.
Hospitals have been given 30 days to respond to the letter. The full document can be accessed here: https://www.cms.gov/files/document/hospital-oversight-letter-generic.pdf.
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