MEDICAL BUSINESS INTERESTS SEEK TO INCREASE REVENUES WITH THE UNKINDEST CUT

NORTH CAROLINA CONCERNED CITIZEN PETITION

Raleigh – North Carolina (December 2020):

North Carolina hospitals want to increase insurance payouts by insanely claiming babies need preemptive surgery to protect them from HIV. For over 10 years North Carolina law prevented this from happening, but now medical lobbying interests want to change that.

MEDICAL INTERESTS SEEK TO INCREASE INSURANCE PAYOUTS

Some North Carolina officials are floating a proposal to alter regulatory policy to have the State Medicaid program reinstitute payouts to hospitals and doctors to perform infant circumcision.  State officials, pressured by medical groups, are trying to insert clever language into Regulation 1A-22 so routine infant circumcision under State Medicaid can be paid for almost any reason. This proposal would remove the current prohibitions on payouts for this surgery.

ATTEMPT TO CIRCUMVENT “MEDICAL NECESSITY” REQUIREMENT

Since medical procedures must meet the definition of “medical necessity,” this proposal is an attempt to circumvent that requirement. If they can get this passed, North Carolina hospitals and clinics would obtain steady insurance payouts for needlessly cutting baby boys’ genitals. This is in violation of the intent of State law and an unauthorized Medicaid expansion.

BILLING CODE MANIPULATION

Billing codes are easily manipulated by medical staff. Here’s a scenario on how it might playout. When a baby boy is born the doctor would solicit circumcision.  He convinces the parents to sign a consent form and hospital coder/biller enters “HIV prophylaxis” on the chart. Doctors and nurses can even coach parents by telling them a medical procedure can prevent HIV. By claiming “HIV prophylaxis” it basically covers any excuse so doctors can get payouts for circumcisions – in violation of the intent of State Medicaid law.

PARENTS WILL BE PRESSURED TO CONSENT

Evidence has shown that when payment is guaranteed, doctors solicit or pressure Medicaid recipients into signing consent forms for circumcision on their sons, telling them it’s “free.” Mothers are often recovering from delivery and the effects of anesthesia. They are incapable of giving informed consent in the moment. Hospitals and clinics are then inclined to rush the procedure or use poorly trained personnel to reduce costs. As past incidents have shown, when malpractice or disfigurements happen, medical staff lie to parents and downplay the consequences.

BLACK AND BROWN BABIES AT GREATER RISK FOR MALPRACTICE

Documented incidents have shown children of Medicaid recipients are more at risk for botches, malpractice, and complications from inadequately trained and supervised medical staff than their non-Medicaid counterparts. More often than not, it’s Black, Brown, and Latino babies that suffer disproportionately from circumcision malpractice. These children must often endure the rest of their lives with physical impairments and psychological harm.

INSUFFICIENT EVIDENCE CIRCUMCISION PREVENTS HIV

The whole thing is preposterous because babies are not at risk for sexually transmitted HIV. Many medical experts have stated, ““CIRCUMCISION fails to meet the commonly accepted criteria for the justification of preventive medical procedures in children…”

NO COST BENEFIT ANALYSIS PERFORMED

Despite claiming the reason for the proposal as “HIV prophylaxis,” officials have not made a case on how circumcision would be cost effective in an era of declining infection rates and effective medications. No in-state cost benefit analysis was ever produced despite our repeated requests to North Carolina Medicaid officials.

north Carolina Medicaid circumcision

North Carolina Medicaid Proposes To Enrich Hospitals With Profits From Routine Infant Circumcision

THE PETITION

We will deliver this petition to North Carolina Governor Roy Cooper and legislators of the General Assembly

IF YOU ARE A NORTH CAROLINA RESIDENT – TAXPAYER – VOTER

YOU NEED TO SIGN THIS PETITION !

I oppose North Carolina Medicaid’s draft proposal to fund Routine Infant Circumcision (“RIC”), entitled “Necessary Circumcision Clinical Coverage Policy 1A-22.” For over ten years, North Carolina declined to cover RIC, citing it as cosmetic and unnecessary.  RIC does not meet Medicaid’s definition for medical necessity.

State Medicaid has proposed to insert backdoor language into 1A-22 that would essentially allow circumcision payouts for almost any reason, in violation of the intent of state law.  All healthcare providers would need to do in order to receive payment for RIC would be to note “HIV prophylaxis.” It’s a preposterous excuse because babies are not at risk for HIV, no western studies have shown a link between circumcision and HIV rates, and the State has not provided any in-state data on “female to male” HIV versus circumcision status.

Medical experts have stated, “CIRCUMCISION fails to meet the commonly accepted criteria for the justification of preventive medical procedures in children … Circumcision of underage boys … has no compelling health benefits, causes pain, can have serious long-term consequences, constitutes a violation of the U.N. Declaration of the Rights of the Child, and conflicts with the Hippocratic oath: primum non nocere: First, do no harm.”

Proposal 1A-22 will only serve to increase revenues for hospitals and doctors at the expense of the Medicaid program and the taxpayers of North Carolina. Furthermore it’s the baby boys that must suffer from needless traumatic pain, loss of choice for an intact body, and loss of anatomically important erogenous tissue.  Circumcision payments were ended in 2009, but now medical industry advocates are attempting to relitigate the issue and revive this income stream once again.

The 1A-22 Proposal relies on the most positive assumptions about the claimed benefits of circumcision, assumptions that are disputed by medical experts around the world. The proposal does not consider the risk and complications that arise from RIC. More often than not, it’s Black, Brown, and Latino babies that suffer disproportionally from circumcision malpractice. Doctors will solicit or pressure Medicaid families into signing consent forms for circumcision on their sons, telling them it’s “free.”  Hospitals and clinics are inclined to rush the procedure or use poorly trained personnel to maximize revenues. When malpractice or disfigurements happen, medical staff downplay the consequences and tell the parents not to worry, it will heal. These children must often endure the rest of their lives with physical disfigurements and psychological harm.

Furthermore, the State did not perform any cost benefit analysis on circumcision. No analysis was done on what financial impact Proposal 1A-22 would have on the State Medicaid program. In addition to the billing charge for the procedure, other cost factors that must be included are complication rates, botches, malpractice, and circumcision revision surgery expenses, including cosmetic repairs, by pediatric urologists. The complete costs are vital to know in an era of our overburden medical system and state budgets already impacted by COVID-19 costs. Yet the 1A-22 Proposal did not seem to consider these things at all.

North Carolina Medicaid should not be pay for unnecessary, cosmetic, life altering surgery on babies. The changes contained in the proposed 1A-22 Policy should be rejected.

Please Sign The North Carolina Petition !

Your information will only be used for the purposes stated in the petition and for communication from the Health Equality Campaign/Intaction. We will not release  your information to third parties.

This petition has obtained 203 supporters!

health equality campaign circumcision

The Health Equality Campaign Inc. is a 501 (c)4 non profit organization. The Campaign works to ensure all Americans have increasing opportunities to live the healthiest life possible. Further information can be found here: www.healthequalitycampaign.org