Medicaid limits coverage for circumcisions

Procedure must be medically necessary

BY ELINOR J. BRECHER
ebrecher@herald.com

Correcting inaccurate information released to physicians and the media last month, Florida Medicaid officials now say that the state program covering some medical expenses for the poor will pay for circumcisions only when they are medically necessary.

Initially, officials said that elective circumcisions billed as part of the delivery process also would be covered.

Medicaid will still pay for the procedure -- surgical removal of the foreskin -- at any time if a doctor deems it medically necessary, usually because of infection, injury or abnormality that impairs function.

The move was part of a legislative cost-reduction measure designed to save the state $2.3 million. It took effect July 1.

''If it is not medically necessary to perform a circumcision at the time of the newborn's delivery, that service will not be covered,'' said Jessica Cary, a spokeswoman for the Agency for Health Care Administration.

Initially, she said, Medicaid ``announced that these procedures would be reimbursed if performed at the time of delivery when the newborn was still hospitalized. Unfortunately, an incorrect . . . message was posted.''

She was unable to say Friday whether Medicaid will pay providers for the procedure during delivery since July 1.

Nationwide, according to the National Center for Health Statistics, about 60 percent of baby boys undergo the procedure, even though The American Academy of Pediatrics has said that the benefits of circumcision were not strong enough to warrant recommending it as a routine procedure.

Medicaid paid $106,630 for 659 procedures in Miami-Dade County in 2001-2001 and $122,656 for 677 in Broward, state Medicaid records show.