CommercialAdministrativeMedium impact
PAP701 - Federal Employee Program Benefit Requirements - Gender reassignment surgery is not covered for 2026.
Blue Cross of Idaho·Medical Policy
Effective date
Aug 1, 2005
We identified it
Jun 19, 2026
Summary
This policy (PAP701) covers Federal Employee Program (FEP) coordination of benefits procedures when patients have dual coverage. Despite the misleading title mentioning gender reassignment surgery exclusions for 2026, the actual policy content focuses on COB billing requirements and does not contain any coverage exclusions for gender reassignment procedures.
Action Required
Billing team should review current FEP coordination of benefits procedures to ensure compliance with COB requirements. When submitting secondary claims electronically for FEP patients, verify that practice management software includes all required COB elements (COB type, amount, allowance, deductible, copayment, coinsurance, and member liability). Ensure staff understand that FEP participating providers cannot balance bill patients and must accept primary plan allowances.