North Carolina’s Medicaid Program to No Longer Cover Circumcision
North Carolina's Medicaid program will no longer cover circumcision as of Nov. 1, affecting about 17,000 male infants per year, the Raleigh News & Observer reports. The measure, which was passed "quietly" by the General Assembly earlier this fall, will save the state an estimated $246,000 this year and $400,000 next year. Pediatricians and obstetricians complained that the new policy creates a "two-tiered system that readily identifies people who have money from those who don't" and said the change was made without doctors' input and with little warning. "If we knew this would happen next year, people could plan for it. Such short notice for women who are already pregnant is difficult and burdensome," Dr. Valerie Parisi, chair of the obstetrics and gynecology department at the University of North Carolina at Chapel Hill, said. Daphne Lyon, deputy director of the state Division of Medical Assistance, which administers the state's Medicaid program, said legislative budget writers requested a list of Medicaid-covered procedures that were "not medically necessary." The list her department submitted included circumcision, chiropractic coverage, podiatry and private-duty nursing, but circumcision was the only one selected by the General Assembly. According to Parisi, UNC Hospitals will absorb the cost of the procedure for Medicaid patients who deliver next month and she is working with colleagues across the state to draft a position paper advocating that Medicaid resume paying for the procedure. She noted that although it does not recommend "routine" circumcision, the American Academy of Pediatrics said in a 1999 position paper used by state Medicaid officials as a guideline that it is "legitimate for parents to take into account cultural, religious and ethnic concerns, in addition to medical factors, when making this decision." Dr. William Hubbard, president of the N.C. Pediatric Society, said the state had "effectively ... eliminated" the choice for parents on Medicaid by opting not to cover the procedure. "As advocates for children, the N.C. Pediatric Society would like Medicaid families to have the same choices for children that everybody else has," he said, adding that the policy will create a "real hardship" (Avery, Raleigh News & Observer, 10/31). For further information on state health policy in North Carolina, visit State Health Facts Online.
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