EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

COMMONWEALTH OF MASSACHUSETTS
ONE ASHBURTON PLACE, BOSTON, MA 02108
(617) 573-1600

MAURA T. HEALEY KATHLEEN E. WALSH

GOVERNOR SECRETARY

KIMBERLEY DRISCOLL
LIEUTENANT GOVERNOR

Via e-mail
September 12, 2023

Megan Brock
Daily Caller News Foundation
meganbrock@dcnf.org

Re: Public Records Request Dated July 11, 2023 – Payments of Claims for Related to
Certain Gender Reassignment Insurance Codes Covered by MH and CHIP

Dear Megan Brock,

The Executive Office of Health and Human Services (EOHHS) responds to the above-referenced
public records request (PRR) received on July 11, 2023, and revised on July 26, 2023, wherein
you requested the following:

1. Please provide any/all records of all payments requested, amount accepted, and/or
any/all financial records (including but not limited to invoices, pink slips, and
receipts), for reimbursed care that contains any/all of the following attached ICD-10
and/or CPT and/or HCPCS Codes, for procedures for children 18 and under covered
through any/all Massachusetts Medical Assistance programs, including, Medicaid,
the Children's Health Insurance Program (CHIP) and any affiliated MassHealth
program. Please provide records for the timeframe of January 1, 2018, to May 31,
2023.

2. Please provide any/all records of all payments requested, amount accepted, and/or
any/all financial records (including but not limited to invoices, pink slips, receipts,
for reimbursed care), that contains any/all of the following attached ICD-10 and/or
CPT and/or HCPCS Codes, procedures covered through Massachusetts Medical

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 Assistance programs, including, Medicaid, MassHealth, and/or any affiliated
MassHealth program for all patients 18 and older. Please provide records for the
timeframe of January 1, 2018, to May 31, 2023.

3. Please provide any/all records of all payments requested, amount accepted, and/or
any/all financial records (including but not limited to invoices, pink slips, receipts,
for reimbursed care), that contain any/all of the following attached ICD-10 and/or
CPT Codes and/or HCPCS, for procedures for children 18 and under the occurred
within the Boston Children’s healthcare system and covered through any/all
Massachusetts Medical Assistance programs, including, Medicaid, the Children's
Health Insurance Program (CHIP) and any affiliated MassHealth program. Please
provide records for the timeframe of January 1, 2018, to May 31, 2023.

4. Please provide any/all records of all payments requested, amount accepted, and/or
any/all financial records, including but not limited to invoices, pink slips, receipts,
made to the American Medical Association, from January 1, 2018, to May 31, 2023,
made by the state of Massachusetts or care provide through any Massachusetts
Medical Assistance programs, including, Medicaid, the Children's Health Insurance
Program (CHIP) and any affiliated MassHealth program.

Additionally, the American Medical Association receives royalty payments of the use of
CPT codes. Please provide any/all records of payments requested, amount accepted,
and/or any/all financial records (including but not limited to invoices, pink slips,
receipts) showing payments, donations, or dues paid to the American Medical
Association and/or state insurance providers, for the use of the following CPT codes for
children 18 and under. Please provide records for the timeframe of January 1, 2018, to
May 31, 2023.

On July 26, 2023, you revised your PRR and withdrew items #1 and #3.

With respect to item #2, the records you seek do not exist as a single record or segregable portion
of a larger record within EOHHS’ possession, custody, or control. To identify, segregate, and
produce this information would require advanced data analysis and the development of new
coding. An agency is not required to perform advanced data analysis or develop coding to
respond to a public records request. Any record created by advanced data analysis and the
development of new coding would constitute a new record for purposes of the Public Records
Law. An agency is not required to create a new record in order to respond to public records
requests. M.G.L. c. 66, §6A(d).

As a courtesy, in response to item #2, EOHHS provides the following chart which represents
claims with procedure codes identified in the attachment submitted with your July 11, 2023 PRR

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titled “Gender Reassignment Insurance Codes” and which had relevant ICD-10 diagnoses for
Gender Transition claims.

Age Group CY AMT_PAID

18 and Over 2018 $ 843,981.60
18 and Over 2019 $ 1,248,188.13
18 and Over 2020 $ 1,482,222.03
18 and Over 2021 $ 2,393,563.35
18 and Over 2022 $ 2,677,974.70
18 and Over 2023 $ 1,176,266.52*

Please note, only final paid versions of claims were considered from MassHealth providers.
MassHealth members’ ages were calculated as of the date of service on the claims. The amount
paid for CY2023 is year-to-date.

In response to item #4 and the remainder of your request, EOHHS has no responsive records in
its possession, custody, or control.

EOHHS now considers your request closed.

EOHHS reserves the right to retrieve any exempted, privileged, or otherwise protected materials
inadvertently included in this production. Any such production is not, and shall not be considered
or deemed, a waiver of any applicable privileges or protections from disclosure.

Pursuant to G.L. c. 66, § 10A, if you believe the agency has violated G.L. c. 66, § 10 and you
made your request in writing, you may submit an appeal to the Supervisor of Public Records in
the Office of the Secretary of the Commonwealth or seek judicial review by commencing a civil
action in Suffolk Superior Court.

Sincerely,

Hayley Carr
Records Access Officer

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