Medicaid providers sometimes come under fire for denying care to enrollees, but Florida has taken the unusual step of doing the opposite, in the case of transgender care.
Since August 2022, Florida’s Agency for Healthcare Administration (AHCA) has banned the use of taxpayer funds to pay for transgender treatments. After an audit this August, Florida discovered five Medicaid providers—Simply, Sunshine, Children’s Medical Services, Molina, and Humana—ignored the rule. Each has received unspecified fines for providing cross-sex hormones and puberty blockers for children.
Simply Healthcare was sanctioned and received a $30,000 penalty for covering a double mastectomy for a minor seeking “gender-affirming care.”
Sanctioning can block a provider from receiving future state contracts.
“The Agency has not been challenged for any of the fines. Florida Medicaid will continue to solicit audits of health plans and providers to ensure the integrity of Florida’s program,” said Baily Smith, a spokesperson for the AHCA.
Federal Court Action
On September 1, U.S. District Judge Robert Hinkle refused to issue a preliminary junction blocking Florida’s law limiting transgender treatments not just on children, but adults. The law (SB 254), signed by Gov. Ron DeSantis this spring, requires patients to sign informed-consent forms written by state medical boards, allows only physicians to prescribe cross-hormone treatments, and bans the use of telehealth to receive such prescriptions.
Doctors are prohibited from ordering transgender treatments for children but are allowed to continue treatment in some circumstances for minors already receiving the drugs.
Hinkle said he would be open to issuing a narrowly tailored injunction for individual plaintiffs after reviewing detailed medical records. In June, Hinkle did temporarily block portions of Florida’s law.
Related cases involving transgender treatment restrictions in other states are working their way through the federal courts and could ultimately impact what happens in Florida. Until then, Florida plans to continue audits of Medicaid providers.
“Florida was the first state in the nation to review the scientific research on the effectiveness of these treatments,” said Smith. “Similar to other developed nations that have outlawed these treatments, Florida puts evidence over eminence.”