Here are four things to know about the ruling.
1. The appeals council upheld an April 2015 decision by an HHS administrative law judge that the woman’s UnitedHealthcare/AARP Medicare Complete insurance plan, operated by a unit of UnitedHealth Group, must cover the surgery.
2. In the ruling, the appeals council did not agree with UnitedHealthcare’s argument that Charlene Lauderdale, a U.S. Air Force veteran, shouldn’t receive the surgery because she had suffered psychiatric problems, which led to four hospitalizations in 2014, according to the report. The council also noted that untreated gender dysphoria can lead to psychological distress, according to Reuters.
3. According to Reuters, Ms. Lauderdale’s lawyer, Ezra Young, said this ruling was the first time HHS ordered a Medicare Advantage plan to cover sex reassignment surgery, and believes it will set an important “guidepost” for the future.
4. A spokeswoman for UnitedHealthcare could not immediately be reached for comment last week by Reuters.
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