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Elizabeth M. Whitehorn, Director

Provider Notice issued 10/06/2026

Federal Rule on Gender Affirming Care for Young People 

To:
 All Medical Assistance Program Providers
​Re:
 Federal Rule on Gender Affirming Care for Young People 
Date:
 October 6, 2026

This notice is to inform all providers of the new federal rule, effective October 13, 2026, regarding gender affirming care for youth. The federal rule does not prohibit states from using state-only funds to cover the gender affirming care services at issue when federal match is no longer available. HFS will use state-only funds to preserve continuity of care and coverage through the end of state fiscal year 2027. Decisions regarding funding for state fiscal year 2028 will be determined through the budget development process. 

Providers should continue following all existing billing instructions for these services, including those provided in the 01/09/2020 Provider Notice and 11/26/2024 Provider Notice. HFS’ compliance with the federal rule will be achieved on the back end by not claiming federal matching dollars on impacted claims. All providers may continue covering and billing Medicaid fee-for-service or Medicaid Managed Care Organizations (MCOs) for all related services. 

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565, or the applicable MCO.

 

Laura Phelan, Administrator 
Division of Medical Programs