North Carolina Medicaid Bulletin: Circumcision Policy for Newborns

North Carolina Medicaid Bulletin No. 10 (PDF file) ^ | Oct 2001 | North Carolina Department of Health and Human Services

[intacto]

North Carolina Medicaid Bulletin Number 10 October 2001

Attention: All Providers

Circumcision Policy for Newborns

Effective with date of service November 1, 2001, the N.C. Medicaid program will no longer cover routine newborn circumcisions. Medically necessary circumcisions will continue to be covered for all male recipients.

The American Academy of Pediatrics (AAP) policy on circumcision states that the benefits are not significant enough for the AAP to recommend circumcision as a routine procedure.

Physicians who perform routine circumcisions must follow the guidelines set forth in the North Carolina Administrative Code at 10 NCAC 26K.0106 concerning billing recipients for this noncovered service. Medicaid must not be billed for noncovered services.

Hospital claims must list all expenses related to routine newborn circumcisions as noncovered services and must not bill the family.

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North Carolina Department of Health and Human Services. North Carolina Medicaid Bulletin Number 10. Oct 2001. Page 6

[intacto]

The following question was raised in another thread concerning male circumcision, "Can someone point out the justification for this subject on a political forum?" Discussing the appropriateness of Medicaid funding of routine or non-therapeutic infant male circumcisions is one justification. Should taxpayer’s hard earned money be spent on medically unnecessary surgery?

North Carolina now joins several other states which have ended Medicaid funding for non-therapeutic infant circumcision, including California, Mississippi, Nevada, North Dakota, Oregon, and Washington. No national professional medical organization in the world now recommends that infant boys should be circumcised because the medical benefits of the procedure do not far outweigh the medical risks and harms.

[Ratatoskr]

"Intacto"? Let me guess: one-issue boring zealot, are you?

[Rustynailww]

smegma.

[dbbeebs]

"Should taxpayer’s hard earned money be spent on medically unnecessary surgery? "

No.

[snopercod]

smegma That used to be my password on the NASA computer system when I worked at KSC.

[snopercod]

Uh-oh, it's the "helmets" versus the "anteaters".

[ikanakattara]

Yes, Medicaid should pay for it, and this is why. While most middle-class parents would properly care for an uncircumcised baby and maintain good standards of cleanliness, I'm not so sure about welfare mothers.

Occasionally uncircumcised babies and toddlers DO get infections. Again, most middle-class moms would run their kids right to the pediatrician, and treating the infection would be no problem. Welfare mothers, on the other hand, would most likely let the infection get quite extreme before showing up at the emergency room, which ultimately costs the state more.

The final issue is the link between no circumcision and cervical cancer in women. Right now there's an indication that lack of circumcision leads to cervical cancer in the female partner. This is a significant public health problem in and of itself, and if the woman who gets cervical cancer is also on Medicaid, then there's just more public health cost down the line. While no one should be *forced* to have their boy circumcised, on the other hand it seems that paying for it for the poor would be justfied as a public health measure.

[snopercod]

One thing...

Medicaid doesn't pay for anything. You and I do.

[MaryFromMichigan]

I heard that there is an opening at the circumcision department at our local hospital.
The pay isn't so great, but you can keep the tips......
(groan)

[Cicero]

I don't trust this new medical theory that suddenly circumcision has no health benefits, although the benefits have always been well known. I think it represents a covert anti-religious bias, which in these times is pretty much par for the course in the AMA.

[Clara Lou]

the medical risks and harms
Exactly what are the risk and harms? I have 3 circumcised boys-- not a one had a problem of any sort. Please explain.

[Age of Reason]

Occasionally uncircumcised babies and toddlers DO get infections.

So we should have doctors hack-off every body part prone to a possible infection?

There might not be much left.

[Irene Adler]

I know a woman who had her ovaries prophylactically removed due to a history of ovarian cancer in her family. Prophylactic surgical measures are taken when the situation merits in the judgment of the patient or the patent's guardian and the physician.

This has come to look more and more like a covert gay-straight issue to me. I have recently become aware from several news articles, as well as from my own knowledge from gay family members that gay men tend to dislike circumcision. An underhanded political campaign against circumcision seems to me to be under way. I think parents and physicans should be free to make their own decisions regarding this practice without pressure from gender-lefty, PC buttinskys with covert agendas.

[intacto]

And what does this have to do with mutilating a male child with a barbaric religious ritual practice?

I would have phrased the question in the following way ... And what does this have to do with medically unnecessary genital surgery on infant boys done for social or cultural reasons?

Non-religious routine or non-therapeutic infant male circumcision is a misguided medical practice, not a religious ritual. It is done mainly for social or cultural reasons.

Furthermore religious circumcision is not a medieval tradition. It is a religious practice of Muslim and Jewish people that is many thousands of years old. Male circumcision is not a religious requirement for Christians.

[intacto]

The final issue is the link between no circumcision and cervical cancer in women. Right now there's an indication that lack of circumcision leads to cervical cancer in the female partner.

That indication is based on outdated research that did not take into account the proven risk factors of cervical cancer. The American Cancer Society (ACS) does not even list the circumcision status of a woman's sexual partner as a risk factor for cervical cancer.

The ACS lists the following risk factors for cervical cancer: (1) age, (2) race and ethnicity, (3) human papillomavirus (HPV) infection, (4) smoking, (5) HIV infection, (6) diet, (7) oral contraceptives, and (8) low socioeconomic status.

"The most important risk factor for cervical cancer is infection by human papillomavirus."

"Certain types of sexual behavior increase a woman's risk of getting HPV infection. These high-risk sexual behaviors include intercourse at an early age, having many sexual partners, and having unprotected sex at any age."

American Cancer Society. What Are the Risk Factors for Cervical Cancer?.

[Clara Lou]

You're a little on the slow side, aren't you? What part of my question to Intacto do you not understand? All of it?