Final Rule: Prohibition on Federal Medicaid and CHIP Funding for Sex Rejecting Procedures Furnished to Children and Youth (CMS-2451-F)
This final rule requires that a State Medicaid plan must provide that the Medicaid
agency will not make payment under the plan for sex-rejecting procedures for children under 18,
and prohibits the use of Federal Medicaid dollars to fund sex-rejecting procedures for individuals
under the age of 18. In addition, this final rule requires that a separate State Children’s Health
Insurance Program (CHIP) plan must provide that the CHIP agency will not make payment
under the plan for sex-rejecting procedures for children under 19, and prohibits the use of
Federal CHIP dollars to fund sex-rejecting procedures for individuals under the age of 19.
Significant Guidance Status ID: 0938-AV73
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 11, 2026
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.