In separate actions yesterday, CMS and the New York State insurance regulatory authority took steps to (a) assure equal treatment of same-sex spouses by hospitals and (b) insurance coverage of medically necessary transgender treatment by health insurers.

The CMS action took the form of a proposed rule making it a condition of Medicare and Medicaid participation that a hospital accord the same-sex spouse of a patient all rights that are accorded to an opposite-sex spouse.  Those rights generally include, among others, rights of visitation and consent to treatment when the patient is incapacitated.  The announcement cites the Supreme Court’s landmark decision in U.S. v. Windsor striking down of the Defense of Marriage Act as unconstitutional.

In New York State, the State Department of Financial Services, which supervises insurance companies, issued a regulation stating that it is illegal—under both federal and state law—for health insurers to deny medically necessary treatment for transgender people.  The regulation is based on a 2006 New York State statute, Timothy’s Law, mandating that health plans provide mental health coverage on a par with physical health coverage, and also on a federal regulation interpreting the Mental Health Parity & Addiction Equity Act as prohibiting insurers from putting more restrictions on mental benefits than on other medical or surgical benefits.