Florida is on the bill in Medicaid transgender case

TALLAHASSEE (Florida News Service)

Gov. Ron DeSantis’ administration has approved more than $1.3 million in attorneys’ and witnesses’ fees in the state’s effort to ban Medicaid coverage of treatments for transgender people, according to a review of state records by The News Service of Florida shows.

The Agency for Health Care Administration, which largely oversees the Medicaid program, last year enacted a rule barring coverage for hormone therapies, puberty blockers and surgery, which the LGBTQ community rebuffed. The treatments will be used for people with gender dysphoria, which the federal government defines as clinically “significant distress that a person may feel when gender or the sex assigned at birth does not match their identity.”

Four plaintiffs, including two children, filed a federal lawsuit challenging the rule, arguing that the prohibited treatments for gender dysphoria are “medically necessary, safe and effective.”

The state agency awarded a nearly $1 million contract in July for legal services and costs in the lawsuit.

According to state records, the DeSantis administration was also willing to pay up to $322,323 for the services of “expert witnesses” from seven physicians and researchers who contributed to an AHCA report or appeared at a public hearing on the subject. The researchers received a total of $42,621.83 from orders placed between May and August of last year.

Many of the state experts are affiliated with religious organizations or have advocated “conversion therapy,” which aims to change the sexual or gender identity of LGBTQ people. Large sections of the medical community have discredited the practice.

The state’s highest-paid expert, California-based general practitioner Andre Van Mol, was paid $15,104.55 for his advice out of an approved total of nearly $70,000. Van Mol has written extensively on treating gender dysphoria for groups such as the Christian Medical & Dental Associations. Van Mol is also on the board of directors of Moral Revolution, a group that describes itself on its website as “a team of passionate individuals called to advance God’s original design for sexuality.”

The state agency paid Quentin Van Meter, an Atlanta-based pediatric endocrinologist, $12,417.28 in July, records show. Van Meter is the executive chairman of the American College of Pediatricians, which says on its website that “transgender interventions harm children.” This group differs from the American Academy of Pediatrics, which supports gender-affirming care.

Van Mol and Van Meter both appeared as experts for the state during a July 8 hearing on the rule.

The state also paid $9,600 to James Cantor, an American-Canadian psychologist. Cantor has also worked as an expert for the Alliance Defending Freedom defending a West Virginia ban on female trans athletes participating in all-girls school sports.

Another state expert, Patrick Lappert, also has ties to the Alliance Defending Freedom, an organization that says on its website that it is “a leader in defending religious freedom, free speech, the sanctity of life, parental rights and God’s plan.” for marriage and family.” The state awarded a $34,800 contract for Lappert’s work, but records show he has not received any payments.

Psychiatrist Miriam Grossman received $5,500, according to state files. Grossman “believes that every child is born in the right body,” according to her website. Grossman’s research has been cited in conversion therapy efforts.

The state also issued purchase orders for $34,650 each for Romina Brignardello-Petersen, a professor at Canada’s McMaster University, and Gerard Kevin Donovan, a pediatrician who opposes gender-affirming underage care. According to the records, none of the experts were paid by the state in the past year.

Many of the researchers who helped draft the Medicaid rule are serving as testimonials for the state in the lawsuit challenging the rule, but it’s unclear how much they’ll be paid.

The expert witness fees in the case will be processed through the law firm of Holtzman Vogel Baran Torchinsky & Josefiak, PLLC. The Agency for Health Care Administration in July approved a $950,000 contract for the firm to represent the state in the lawsuit. The firm previously signed separate contracts totaling $28,830 for “legal counsel and representation in matters including but not limited to Medicaid rulemaking and subsequent litigation.” The state has paid Holzman $220,938.50 so far, records show.

The controversial rule followed the June 2 AHCA report, which included research by state experts. The report said the Medicaid program “has determined that there is insufficient research to support sex reassignment treatments to demonstrate efficacy and safety.” Treatments such as puberty blockers and hormone therapy are “experimental and under study,” the report concluded national medical and legal researchers condemned.

A report issued by seven scientists and a Yale law professor blasted the state study, saying its “conclusions are incorrect and scientifically unfounded.”

An email exchange released late Friday by the plaintiffs in the lawsuit also revealed an analyst with the Agency for Health Care Administration, who plays a role in determining “universally accepted professional medical standards” for the state , has resisted the government study.

The study “did not come through the traditional channels and was not conducted through the traditional process,” agency analyst Jeffrey English wrote in an email to Christopher Cogle, chief medical officer of the Florida Medicaid program.

“I do not select data or studies and would never agree if asked,” wrote English. “All I can say about this report, as I have read it, is that it does not represent an honest and accurate assessment of the status of current evidence and practice guidelines as I understand them in the existing literature.”

The Medicaid rule is among a series of actions DeSantis, widely believed to be the Republican presidential nominee in 2024, and other state leaders have taken to target transgender treatment, particularly for minors. State medical boards recently introduced rules prohibiting doctors from using hormone therapy, puberty blockers or surgery to treat children diagnosed with gender dysphoria.

Meredithe McNamara, a professor at the Yale School of Medicine, one of the authors of the state study’s rebuttal, called Florida taxpayers’ spending under the Medicaid regime “wasteful.”

“It turns out that lies are expensive to manufacture. The DeSantis government claims it is targeting gender-affirming care because it says the coverage is a misuse of state resources. But the lavish spending on a blatant anti-trans agenda shows the hypocrisy,” McNamara, who specializes in youth medicine, told the news service in an email. “Evidence-based measures to protect the standard of care … are completely free … but fabricated disinformation is a bottomless pit into which the state pours public money until it is held accountable.”


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