Gender Transition. The MCOP is prohibited from having or implementing a categorical coverage exclusion or limitation for all health services related to gender transition. This does not prevent the MCOP from determining whether a particular health service is medically necessary or otherwise meets applicable coverage requirements in individual cases. When an individual who has transitioned needs medically necessary services related to their gender at birth, the MCOP must review for medical necessity and cannot categorically deny a service due to gender.
Appears in 4 contracts
Samples: The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan, The Ohio Department of Medicaid Mycare Ohio Provider Agreement for Mycare Ohio Plan
Gender Transition. The MCOP MCP is prohibited from having or implementing a categorical coverage exclusion or limitation for all health services related to gender transition. This does not prevent the MCOP MCP from determining whether a particular health service is medically necessary or otherwise meets applicable coverage requirements in individual cases. When an individual who has transitioned needs medically necessary services related to their gender at birth, the MCOP MCP must review for medical necessity and cannot categorically deny a service due to gender.
Appears in 3 contracts
Samples: Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan, Ohio Medical Assistance Provider Agreement for Managed Care Plan
