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Today is Tuesday, November 27, 2007


HMO Sues State Over Sex Change Surgery

One of the largest health care providers in California is suing the state to prevent paying for a transgender woman's sex reassignment surgery.

Health Net Inc. was ordered by the California Department of Health to provide the woman, identified in court documents only as P.M., with the surgery after the company turned her down.

P.M had appealed to the Department of Health, and an administrative law judge agreed with her doctor that the surgery was necessary. Health Net was ordered to proceed with the surgery.

The company is under contract with California to provide health care under the state's Medicaid plan.

Health Net is suing the state to have the order reversed. The company says sex reassignment operations are not medically necessary.

Brad Kieffer, a spokesman for Health Net, said private health insurers routinely exclude coverage for gender reassignment operations. "Under these circumstances, we think it right and appropriate for us to seek a reconsideration," he said.

A Los Angeles Superior Court judge will decide if the case can go ahead. Until then P.M.'s surgery is on hold.

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