# Texas Medicaid no longer covers circ!



## tsfairy (May 19, 2004)

Yay! I just found out that my new nephew (born 12/20) isn't circed because Medicaid wouldn't cover it! SIL is apparently pretty mad, and my mom thinks they might either try to fight it or go ahead and pay out of pocket, but knowing my SIL she won't make the effort. (This would be the one time I appreciate her lazy parenting style.)

I'm soooo happy. SIL was adamant that the new baby be circed because her other three boys are, and nothing I said could convince her otherwise. So at least now the little guy has a fighting chance.


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## angelpie545 (Feb 23, 2005)

Don't you love it? Washington medicaid doesn't cover it either!







The same thing happened with dh and his ex-gf when she gave birth to their son. They were adament that his son be circ'd, and when they found out that medicaid wouldn't cover it, they demanded that dh pay for it!!!







: Dh flatly refused, despite their angry tirade. Their son wasn't circ'd in the end, though!


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## baybee (Jan 24, 2005)

That's amazing, miraculous, super good news!!!!!! Congrats to everyone in Texas who has been working on this. Thanks to the op for sharing. I'm so excited I'm going to send your post to everyone on my intactivist mailing list.
Yayyyyyy!!!!


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## glongley (Jun 30, 2004)

I did a quick search and cannot find anything official on the Texas Medicaid site on this. There was a Texas Medicaid meeting agenda last Spring in which a Dr. Craig Shoemaker gave a report on the "pros and cons" of circumcision and the AAP recommendations, so maybe they were considering it.

If anybody else from Texas has any confirming information on this, that would be helpful to have.

If it's not defunded by the state itself, I'm wondering if maybe the individual hospital chose not to offer circumcision to Medicaid clients because the state reimbursed too little? (I found another site that listed the payment for circ as $80-something).

It would be great if this is really true...

Gillian


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## Lula's Mom (Oct 29, 2003)

Oh, I hope it's true! I love Texas. I used to live in Dallas and I miss it.


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## QuietTempest (Aug 5, 2004)

If it's true, that's wonderful. All I found on the topic was this:

http://www.icgi.org/Medicaid_Project/index.htm

According to that site, a bill is in legislation regarding the funding for routine circ. It seems a lot of states no longer fund or are considering stopping funding for it.


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## MCatLvrMom2A&X (Nov 18, 2004)




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## glongley (Jun 30, 2004)

Quote:


Originally Posted by *rblissitt* 
Hi All,
I contacted Texas Medicaid several months ago and was told that payments would continue and that "the decision on circumcision was to be made by parents and doctors." Same old, same old. ... Circumcision costs TX Medicaid something like $2.5 million or so every year.

That's what they decided in Colorado too, to continue funding it because the AAP says it should be the parents choice. ARG! Colorado spends only about $275,000 a year on circumcision, so it just doesn't seem like a very big deal to legislators. But sheesh, you'd think $2.5 million would make Texas legislators sit up and take notice.

Do you have the editorial from the November Journal of Urology (vol. 176, p 1911, Nov 2006) by Jack Elder which argues against routine circumcision, calling it a cosmetic procedure, and as such, "the cost of circumcision should be paid out of pocket rather than by the insurance company or by the public incases of Medicaid"? [Anyone who wants it can PM me and send me your email address, and I can send you the file.] This would be good for all of us to send to our state legislatures for another round of consciousness raising.

Gillian


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## bunniemunch (May 28, 2005)

april 2004 round rock texas hospital, we were asked several times if we be circing but then again we had medical insurance. i cant imagine anyone in texas being happy with this, very circ happy state

ggrrr


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## baybee (Jan 24, 2005)

<<
I contacted Texas Medicaid several months ago and was told that payments would continue and that "the decision on circumcision was to be made by parents and doctors." Same old, same old. I hope they'll de-fund soon (or better, they've somehow de-funded already). I've sent many letters, emails, and faxes on this subject to TX legislators. Circumcision costs TX Medicaid something like $2.5 million or so every year.

-robert in dallas
www.luckystiff.org>>

Robert, thanks for coming into this discussion. Please keep us updated.
Baybee


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## DocsNemesis (Dec 10, 2005)

Yep, I'm in WA too and thats what saved my son. You know, I think its a great educator for those who just dont know. For a lot of people hearing "oh, you will have to pay for it cause medicaid doesnt pay anymore since it is concidered a cosmetic issue" can really make them go, wait, huh? It kind of struck me that way at the time-it was the first time I had though maybe there wasnt a good reason to do it-and since it was cosmetic I wasnt about to pay for it







. So my son stayed intact and then later I found out how lucky I was! I know soooo many people who dont get it done purely because they dont want to pay the $300 for the procedure-including upper and middle class people, which I find rather funny







Kind of shows just how important it is to them! Unfortunately I know at least one OB who does them for free







Wierdo.


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## Plummeting (Dec 2, 2004)

According to the AAP, in 2004/2005, Texas Medicaid paid only $50.75 for newborn circumcisions. And the Texas Children's Health Plan only requires doctors to get prior authorization for circumcisions performed on children over one year old. Apparently, any child under 12 months old automatically qualifies for the immediate removal of that pesky foreskin.







:


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## mothragirl (Sep 10, 2005)

Quote:


Originally Posted by *DocsNemesis* 
Unfortunately I know at least one OB who does them for free







Wierdo.

uke

i can't imagine that is true knowing the attitude toward circing in texas. i think there would be an uproar.


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## smeep (May 12, 2006)

Yaaaaaaaaaaaaaaaaaaaay!!!!!!!!!!!!!!!!!!


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## baybee (Jan 24, 2005)

One of the docs at Doctors Opposing Circumcision wrote to me today to say that they are not sure if this is true but it happened the same way when a different state ended Medicaid funding---everyone found out from a Mom posting on a message board!

I would love to have a good "media spin" on this news once we get confirmation. We need to generate news instead of letting Auvert do his spinning.
Baybee


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## baybee (Jan 24, 2005)

It's confirmed!!!

Gloria:

We have confirmation of this. Texas stopped paying for CPT code 54150 circumcisions sometime last year. 54150 denotes neonatal circumcision performed with a clamp. This is the common type of circumcision.

Furthermore, it appears that 48 percent of births in Texas are funded by Medicaid. So 48 percent of boys will not be covered by circumcision.

There are about 194,000 boys born annually in Texas.

That means that 93,000 boys will not be covered for circumcision.

This is huge because Texas is huge.

This could mean a drop of 50,000 circumcisions per year.

This could drop Amerca's circumcision rate by 3 percent.

George,
Doctors Opposing Circumcision


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## smeep (May 12, 2006)

omg Baybee thanks THAT MAKES ME SO HAPPY!!!!!!!!!!!!!!


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## baybee (Jan 24, 2005)

I'm doing backflips up here in Canada!!! I just can't believe that they never made any announcement about it or even let the intactivists in Texas know that they had won their victory. We have to get some press on this---it is huge news. Is anyone on this board a publicist, journalist, or. . . .???

This is a draft press thing that I put together after reading a press story from Florida. We need some Texas quotes and reactions.

*Texas Joins 14 Other States in Dropping Circumcision from Medicaid Funding*

The second largest state in the union has joined California, Oregon, Washington, Florida and other states in saying "no" to circumcision. In a move that will save taxpayers millions of dollars, Texas stopped paying for CPT code 54150 circumcisions in 2006.

There are about 194,000 boys born annually in Texas and 48% of the births in Texas are paid for by Medicaid.

That means that 93,000 boys will not be covered for circumcision.

This could mean a drop of 50,000 circumcisions per year.

This could drop America's overall circumcision rate by 3 percent.

Circumcision involves the removal of all or part of the foreskin of a penis. The removal of the foreskin is a reduction of 50% of the skin of the adult male erect penis. It is now even being questioned as a religious ritual in Judaism and Islam.

Anti circumcision groups have pushed for this change for years. Not only is the foreskin healthy functioning sexual tissue but there is a danger of death or serious injury when boys undergo unnecessary surgery. It is estimated that 200 American baby boys die each year from circumcision related complications.

"This is taxpayer money, and circumcision is a procedure with no medical benefit," said Ronald Goldman, executive director for the Circumcision Resource Center, a Boston-based anti-circumcision group.

"We wouldn't use taxpayer dollars to pay for other cosmetic surgery," Goldman said.

"It's understandable that they would want to cut this funding because the American Academy of Pediatrics has said for many years that circumcisions are cosmetic," said Catherine Lynch, a professor of obstetrics and gynecology at the University of South Florida.

For Ed Rose, head of the Pensacola chapter of the Circumcision Resource Center, the issue is simple: "Being born male is not a disorder requiring surgical correction." Rose has been lobbying lawmakers for years to stop paying for circumcisions.

Pediatricians have been moving further and further away from the procedure as new information about the importance of the foreskin is published in scientific journals. The annual rate of circumcision in the United States is dropping as more parents and professionals are researching the benefits of leaving boys intact. (end of draft)


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## smeep (May 12, 2006)

Baybee, let me know when you finalize this. I want to send it to my local news stations!!! I'm hoping that maybe they will do a piece on it, that would be wonderful.


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## Nia (Oct 2, 2002)

WOW! Wonderful news!!!!


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## onelilguysmommy (May 11, 2005)

thats great, my son wasnt circd, nc medicaid ddint cover ir 22 months ago








my mom asked when it was going to be done, and the doc said that wed have to ay for it to be done- 350.00. my mom said that i better figure out how to pay for it, i said no, then shes like "well, im not, hes your kid!" and im like.. "umm, i didnt tell them to do it to begin with" and she gort mad, and asked that doc, and a few others to explain to me that i tneeded doing :sigh: that one said something about "its not like hes going to be made fun of, the rate here is about 70% not done, mainly because of the mostly catholic people in the area, but medicaid cutting it and rating it as a purely cosmetic prcedure helped to drop it as well" and then she got mad about it being because of catholic people that medicaid doesnt cover it (shes christian, actually trying to be a pastor, but well..not catholic to say the least LOL) and im basically like get over it. ugh. she asked every flippin doc or nurse around to tell me to do it though, literally... nope!

anyway whoever wrote that reply quoted above needs to do math better...not to be rude, but 48% of births in texas not being covered DOESNT mean 48% of boys being born in texas. umm...duh.


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## RestoredIntactivst (Jun 10, 2005)

Quote:


Originally Posted by *baybee* 
Texas Joins 14 Other States in Dropping Circumcision from Medicaid Funding

I've been keeping a running list, and have just added Texas as #17. I'm not sure if these are all accurate, have I jumped the gun on a couple states?

1. CaliforniaSeptember 1, 1982
2. North Dakota1991
3. Oregon1994
4. Mississippisometime before 1999
5. Nevadasometime before 1999
6. Washingtonsometime before 1999
7. MissouriAugust 1, 2002
8. ArizonaOctober 1, 2002
9. North CarolinaDecember 1, 2002
10. MontanaJanuary 1, 2003
11. UtahFebruary 1, 2003 (*circumstitions listed as July 1)
12. FloridaJuly 1, 2003
13. MaineFebruary 3, 2004
14. Louisiana(sometime before April 2005)
15. IdahoJuly 1, 2005
16. MinnesotaSeptember 1, 2005
17. Texassometime in 2006


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## baybee (Jan 24, 2005)

I think you're right about your numbers and states, restoredintactivist.
We're getting there folks, keep on keeping on. Baybee


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## Plummeting (Dec 2, 2004)

Quote:


Originally Posted by *baybee* 
It's confirmed!!!

Gloria:

We have confirmation of this. Texas stopped paying for CPT code 54150 circumcisions sometime last year. 54150 denotes neonatal circumcision performed with a clamp. This is the common type of circumcision.

Furthermore, it appears that 48 percent of births in Texas are funded by Medicaid. So 48 percent of boys will not be covered by circumcision.

There are about 194,000 boys born annually in Texas.

That means that 93,000 boys will not be covered for circumcision.

This is huge because Texas is huge.

This could mean a drop of 50,000 circumcisions per year.

This could drop Amerca's circumcision rate by 3 percent.

George,
Doctors Opposing Circumcision

I wonder if the drop will really be that much. In Texas, Mexican-Americans are the largest ethnic group of recipients of Medicaid benefits. In 2004, Hispanics made up almost 1.3 million of the 2.5 million Medicaid recipients in Texas. Generally, Hispanics don't engage in RIC anyway. I wonder if they took that into account when they came to those numbers. Just something I was thinking about.


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## baybee (Jan 24, 2005)

It's hard to say exactly what the result will be because of all those variables, but it will make the drs and nurses that are "against" circumcision have more power. More will be speaking up to the parents that do have insurance and perhaps more of them will be saved, too. Some that have been on the fence will decide in favour of keeping boys intact.

It's such exciting news. Baybee


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## nd_deadhead (Sep 22, 2005)

I'm always pleased that my normally backwards state of North Dakota was the second in the nation to drop Medicaid funding for infant circumcision!


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## St. Margaret (May 19, 2006)

Wow, CA dropped it back in 1982? And our rate is pretty low (not low enough but relatively good)... could be a sign of good things to come for the other states that are dropping it... it could spread to others (not on medicaid) as a cultural thing. Good for Texas!!


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## lrlittle (Nov 11, 2005)

I gave birth in a public hospital in Houston in Jan '06 and I had insurance. I was pleased to find out that they don't circumsize there at all, insurance or no. It's just hospital policy.







It's a large hospital and most women that give birth there are uninsured. Circumcision is not even a part of discussion. If someone wants it done they have to go elsewhere, and pay for it.


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## Paddington (Aug 25, 2003)

Quote:


Originally Posted by *baybee* 
It's confirmed!!!

Gloria:

We have confirmation of this. Texas stopped paying for CPT code 54150 circumcisions sometime last year. 54150 denotes neonatal circumcision performed with a clamp. This is the common type of circumcision.

Furthermore, it appears that 48 percent of births in Texas are funded by Medicaid. So 48 percent of boys will not be covered by circumcision.

There are about 194,000 boys born annually in Texas.

That means that 93,000 boys will not be covered for circumcision.

This is huge because Texas is huge.

This could mean a drop of 50,000 circumcisions per year.

This could drop Amerca's circumcision rate by 3 percent.

George,
Doctors Opposing Circumcision

Heck! I may just move to Texas!!! AWESOME!!!


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## Paddington (Aug 25, 2003)

Quote:


Originally Posted by *St. Margaret* 
Wow, CA dropped it back in 1982? And our rate is pretty low (not low enough but relatively good)... could be a sign of good things to come for the other states that are dropping it... it could spread to others (not on medicaid) as a cultural thing. Good for Texas!!


Huh? I thought circ was still covered in CA? Just had to be the day you gave birth or something.... DID we drop it????


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## Night_Nurse (Nov 23, 2007)

I realize this thread is over one year old, but are you sure TX Medicaid doesn't cover circ??? Because I live & work in TX and I'm pretty sure Medicaid does still cover it. If they don't, nobody at my hospital is aware of it.


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *Night_Nurse* 
I realize this thread is over one year old, but are you sure TX Medicaid doesn't cover circ??? Because I live & work in TX and I'm pretty sure Medicaid does still cover it. If they don't, nobody at my hospital is aware of it.

You're right it is still covered. Apparently there was quite a bit of chatter about this sometime ago but it didn't make it through.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Night_Nurse* 
I realize this thread is over one year old, but are you sure TX Medicaid doesn't cover circ??? Because I live & work in TX and I'm pretty sure Medicaid does still cover it. If they don't, nobody at my hospital is aware of it.


This could be one of several things. In one of the western states that defunded circumcision, the doctors at one hospital were providing free circumcisions for Medicaid babies. The year after Florida defunded Medicaid circumcisions, the state went on a preferred provider program and several of the PPs offer circumcision as a item in their list of benefits. That issue is being worked on as it was not the intent of the Florida legislature. In another Florida issue, there were doctors who were making false diagnoses of phimosis, balanoposthitis and other male genital problems to justify circumcising boys and getting Florida Medicaid to pay the bill. A number of those doctors are being investigated for Medicaid fraud.

Frank


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## pdx.mothernurture (May 27, 2004)

This is interesting...It would be nice to know for sure one way or another.

Jen


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *pdx.mothernurture* 
This is interesting...It would be nice to know for sure one way or another.

Jen

I am fairly confident in saying that unfortunately Texas still pays for this. Here is a handy map that shows the current progress.


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