Friday, March 10, 2006 - 12:00 AM


U.S. senator wants to know why Medicaid funded sex operations
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By Alicia Mundy
Seattle Times Washington bureau

WASHINGTON — The head of the Senate Finance Committee wants Gov. Christine Gregoire to explain why the state's Medicaid system is paying for erectile implants, sex-change operations and breast enlargements.

Sen. Charles Grassley, R-Iowa, said, in a letter sent Thursday to Gregoire, that he has asked the inspector general of the U.S. Department of Health and Human Services to look at what he considers dubious expenses discovered in the state's 2004 audit.

Grassley, who led the charge in Congress against Medicaid payments for Viagra and other erectile-dysfunction drugs, said his staff members have interviewed Washington's auditor about issues the auditor raised in the 2004 audit.

"I am amazed by the state auditor's findings," Grassley wrote, citing $9,500 spent for gender-transformation surgery for a Medicaid patient; $40,000 on plastic surgery; and more than $100,000 on "unauthorized" breast implants.

However, the state Department of Social and Health Services has disputed some of the auditor's 2004 findings, said state Medicaid director Doug Porter. He noted that no gender-change surgery has been approved since 2001.

Almost all of the patients approved for penile implants were suffering from prostate cancer, and breast-augmentation operations were approved for women who had suffered breast cancer, he said.

"We are not turning Medicaid clients into supermodels," Porter said.

He did note that the agency and the auditor have had a "rocky relationship."

State Auditor Brian Sonntag said Grassley's staff called him in February shortly after news stories about controversial items he had challenged during the audit.

"It was our office's first time to be contacted by a member of Congress," Sonntag said. "I did appreciate the fact that someone cared."

The 2005 audit will include new questions about spending, Sonntag said. He declined to name those before the audit is released next week.

Federal spending for sex changes and sexual-performance enhancements are the kind of hot-button items that provoke ire in the Congress.

In October, Grassley led a Senate vote to prohibit Medicare and Medicaid from footing the bill for Viagra and other erectile-dysfunction drugs starting this year.

Now, Grassley's staff wants to know how costs for more invasive procedures such as penile implants had been justified by DSHS, which oversees Medicaid payments to doctors and hospitals.

Sonntag has also complained publicly that his investigations were stymied by a lack of documentation from DSHS showing that the procedures were medically required and formally approved — a concern Grassley echoed.

"I am troubled by the [state] Department of Social and Health Service's alleged resistance to requests from the State Auditor's Office for access to records to determine if Medicaid funds were misspent," Grassley wrote.

However, Sonntag said his interactions with DSHS have vastly improved in the last year.

He also noted Washington was not the only state billing Medicaid for sexual-performance surgeries and gender transplants.

Gregoire did not comment on Grassley's letter, which she had not seen as of Thursday afternoon.

Alicia Mundy: 202-662-7457 or amundy@seattletimes.com

Are you bummed Rory?
Seriously, this kind of thing is really bs. Spending public money for anything other than typical health care is not right. I hope somebody gets seriously slapped down for this. Yea right - like that will happen.......

Does medicaid or medicare cover prostetics for people missing limbs? Or false teeth? Or glasses?

"Hey, I wonder what happened to those unaccounted-for billions in Iraq."

"But first, we'd better dig to the bottom of this sex-change business.........."

No wonder Congress' approval rating is in the dumper.

Exactly Dan! I believe they are "missing" about $9 Billion ,(with a B). Not counting the endless waste over there every day, in lives, as well as money we borrow from China. Good thing Bill Frist is spending time on new flag burning and gay marraige legislation.

So what you are saying is these expenditures are legitimate because we are at war in Iraq? I really don't see the connection?

No, misappropriated funds should always be investigated. However, why prioritze a drop in the bucket? This is just a "hot-button" wedge issue that is easy to expoit for political gain.

Why snivel about wasting tens of thousands, when we can't locate several billion?

It's like whining about a nosebleed while you're bleeding from your femoral artery.

Nobody said the expenditures were legit......but it's not surprising that this caught Rory's eye while the missing billions seem to cause him no concern at all.

SEATTLE POST-INTELLIGENCER
http://seattlepi.nwsource.com/local/262816_sexchange14.html

Sex changes through the state a go again after policy reversal

Tuesday, March 14, 2006

By CHRIS MCGANN
P-I CAPITOL CORRESPONDENT

OLYMPIA -- The Legislature is having trouble coming to terms with its feelings about taxpayer-financed sex-change operations.

Earlier this year lawmakers added a line to the budget to end the policy when reports based on a 2004 Medicaid audit revealed the state had paid for a sex-change operation and other questionable procedures such as penile implants.

The amendment, which read "no funds ... shall be expended upon gender reassignment surgery or treatment," passed with broad bipartisan support in the House and Senate, and supporters thought the matter had been resolved.

But as the Legislature adjourned last week, leading Democrats reversed themselves and axed the line when they met in a conference committee, which was closed to the public, to reconcile the details of their budget proposals.

House Appropriations Chairwoman Helen Sommers, D-Seattle, said the committee struck the amendment because it may have prohibited surgery for infants born with both male and female reproductive organs.

"That's more common than I thought," Sommers said. "I don't think we should be doing any gender surgery other than that, but I do think that this is appropriate."

Sommers said she was aware the state had paid for sex-change operations in the past.

"I don't think that's appropriate," she said.

Rep. Jim Clements, R-Selah, sponsored the amendment to the House budget.

He said he was disappointed this policy decision had been made in a committee that is not open to the public.

"I'm not going to argue if it's good or bad," Clements said. "Just make (the process) transparent so we can fairly debate these issues, not just let them die in a conference committee."

Clements said if Democratic leaders were concerned about hermaphrodite children, they could have rewritten the amendment to allow surgical intervention in those cases.

As it stands, the state could still use tax dollars for adult sex changes covered by Medicaid, the federal-state program that pays for health care for needy people.

State Medicaid Director Doug Porter has dismissed the sex-change surgery as a sensational issue that has very little effect on the agency.

"We're talking about a handful of people over a long period of time," Porter said.

In 2003 the department changed its approval policy for sex-change operations because the medical community determined medication and psychotherapy were as effective as surgery to treat the condition.

Now the agency insists patients try less costly and less severe interventions before it would approve a sex-change operation.

Clements said the 2004 Medicaid report highlighted many other issues including unauthorized cosmetic surgeries, health services provided for illegal aliens and other apparently fraudulent claims.

"I find it rather disconcerting," Clements said. "My attitude is, and I've said this to (Gov.) Christine Gregoire, you either get a hold of that agency or you're going to have a huge scandal on your hands."

Clements' prediction has already been realized on at least one count.

Last week, U.S. Sen. Charles Grassley, R-Iowa, chairman of the Senate Finance Committee, launched a federal inquiry into the state's Medicaid expenditures.

Gregoire responded to Grassley, saying in a letter Friday that a review of the expenditures in question showed they were allowed by the Medicaid program.

Jason Mercier, a budget analyst at the conservative think tank the Evergreen Freedom Foundation, said striking the amendment banning taxpayer-funded sex changes sends the wrong message to voters.

"It was odd timing," he said. The Legislature "passed this proviso in both bodies to address a problem that they knew was going to get Congress' attention and then they stripped it from their final budget."

Rory,

Come on, man! Have you got any functioning brain cells beyond the capacity to cut and paste? Why did you post this piece? Seeking National Enquirer style sensationalism yet again? Read what you post. It doesn't look like the gov't is actually funding much - if any - sex change operations. Rep. Sommers made a good point regarding infants with sex anomolies at birth. Do you want those conditions covered or not? And why? And Aunty M makes a compelling case for boob and penile implants, given most peoples' obsession with them. What's your take - and why? If you're never going to say anything intelligent, please do the favor of just disappearing again.

And what the heck does your post have to do with "comrade" Gregoire besides her appointing the DSHS Director?

Sincerely,

Salmo g.

Rory is obsessing about sex changing.