Blog Layout

Why Circumcision is Medicaid Fraud

Elite Music Online • Dec 12, 2020

Why Circumcision May be a Looming Multi-Billion Dollar Liability for the Medical Industry 

This article will explain, in detail, why circumcision constitutes Medicaid fraud according to a new legal theory put forth by prominent legal and medical scholars in the Cornell Journal of Law and Public Policy entitled "Is Circumcision a Fraud?

To read a summary of the paper click here.

What is Medicaid?

Medicaid is a government program intended to help Americans with limited resources or income pay medically necessary care. As of 2017, Medicaid provided free health insurance to 74 million people or 23% of Americans. (1) Medicaid is a taxpayer-funded $600 billion government program. (2)


Medicaid Funds Cannot Be Used for Unnecessary Procedures

Under federal law, the use of Medicaid funds are strictly limited to medically necessary care. As Adler et al states:


“Under the federal Medicaid Act, 42 USC § 1396 et seq., practitioners must furnish only medically necessary care.” (3)


In other words, to lawfully use Medicaid funds, physicians must certify that the medical services being provided are medically necessary to be reimbursed for it. 


Non-Therapeutic Circumcision is not Medically Necessary

Non-therapeutic circumcisions are, by definition, not medically necessary. As stated by Adler et al:


“Non-therapeutic medical circumcision, or circumcision that is not needed to treat a medical condition, is an oxymoron.” (4)


This means that circumcisions, when performed for any non-medical reason, such as for cosmetic reasons, are not medically necessary and thus are not eligible to be reimbursed by medicaid. Cosmetic surgery is not covered under Medicaid. 


Non-Therapeutic Circumcisions, or circumcisions which do not treat any medical condition, are unnecessary, unethical and illegal. As is the consensus in the international medical community (5), circumcision has no rational basis in medicine as any purported benefits are misrepresented or exaggerated and do not outweigh the risks and a lifetime of downsides. Circumcision is widely viewed to be unethical (6) as it violates bodily integrity for infants who cannot consent. Furthermore, under U.S. law, parents cannot legally provide consent for unnecessary surgery and doctors cannot perform surgery without consent making circumcision illegal. (7)


38 medical authorities have spoken out calling the practices unnecessary, unlawful and a violation of a doctor's hippocratic oath to do no harm. Click below to read their paper...


Routine Infant Circumcision Constitutes Medicaid Fraud

U.S. Courts have ruled that if someone knowingly makes a false Medicaid claim then that person can be convicted for Medicaid fraud. (8) As stated by Adler et al: 


“Physicians who circumcise bill Medicaid using the billing code Z41: ‘Encounter for procedures for purposes other than remedying health state,’ the subsidiary billing code Z41.2, ‘Encounter for routine and ritual male circumcision’ in the absence of medical indication, and they use the diagnosis group #795 for “Normal newborn.”  (9)


In other words, doctors are diagnosing babies as a “Normal Newborn” which certifies to the Medicaid program that the babies suffer from no medical condition that requires a circumcision. 

Any licensed practitioner knows that “Normal Newborn” is not a diagnosis. Any medical practitioner that makes these designations, yet performs a circumcision regardless, has likely committed Medicaid fraud. Doctors and hospitals that do this are systematically defrauding American taxpayers for profit. These doctors and hospitals are recklessly violating Medicaid law which is wrong and illegal.


Medicaid Oversight and Billions in Damages

The government has recognized that Medicaid funds are at high risk of being misused. As Adler et al states: 


“The U.S. Government Accountability Office designated Medicaid as a program that is at ‘high risk for improper payments,’ including for those that were not medically necessary... Pursuant to 42 U.S.C. § 1396a(a)(30), all states must establish utilization review boards and procedures to reduce unnecessary Medicaid expenditures.” (10)


As of 2011, 18 U.S. states have already stopped allowing the use of Medicaid funds for circumcisions and any use of Medicaid funds for circumcisions in these states would be illegal.


Physicians are still performing circumcisions in the U.S. using Medicaid, as Medicaid pays for about one-third of circumcisions. (11) Federal and state governments have claims against physicians who use Medicaid funds for circumcisions in violation of federal law potentially in the tens or even hundreds of billions of dollars.

Stopping The Fraud

Ronald Goldman, PhD, and Peter Adler are actively suing the state of Massachusetts on behalf of taxpayers for fraudulent use of Medicaid funds. Adler's Journal of Law and Medicine article entitled "Is it lawful to use Medicaid to pay for circumcision?" (12) was the first step towards this lawsuit. Read more about the case (Goldman, Ronald vs. Secretary of the Executive Office of Health and Human Services)


Citations

(1) Terhune, Chad (October 18, 2018). "Private Medicaid Plans Receive Billions In Tax Dollars, With Little Oversight". Health Shots. NPR. Retrieved October 18, 2018.


(2) Franco Montoya, Daniela; Chehal, Puneet Kaur; Adams, E. Kathleen (April 2, 2020). "Medicaid Managed Care's Effects on Costs, Access, and Quality: An Update". Annual Review of Public Health. 41 (1): 537–549. doi:10.1146/annurev-publhealth-040119-094345. ISSN 0163-7525


(3) Adler, Peter W, Robert Van Howe, Travis Wisdom, and Felix Daase. “Is Circumcision a Fraud?” Cornell Journal of Law and Public Policy 30, no. 1 (2020)


(4) Ibid


(5) Frisch, M., Y. Aigrain, V. Barauskas, R. Bjarnason, S.-A. Boddy, P. Czauderna, R. P. E. De Gier, et al. “Cultural Bias in the AAP's 2012 Technical Report and Policy Statement on Male Circumcision.” Pediatrics 131, no. 4 (2013): 796–800. https://doi.org/10.1542/peds.2012-2896.


(6)  Earp, Brian D. “The Ethics of Infant Male Circumcision.” Journal of Medical Ethics. Institute of Medical Ethics, July 1, 2013. https://jme.bmj.com/content/39/7/418.short.


(7) Adler, Peter W, Robert Van Howe, Travis Wisdom, and Felix Daase. “Is Circumcision a Fraud?” Cornell Journal of Law and Public Policy 30, no. 1 (2020)


(8) United States ex rel. Marcy v. Rowan, 520 F.3d 384, 389 (5th Cir. 2008)


(9) Adler, Peter W, Robert Van Howe, Travis Wisdom, and Felix Daase. “Is Circumcision a Fraud?” Cornell Journal of Law and Public Policy 30, no. 1 (2020)


(10) Ibid


(11) Ibid


(12) Adler, Peter W. "Is it lawful to use Medicaid to pay for circumcision?" J Law Med. 2011 Dec;19(2):335-53. PMID: 22320007. https://pubmed.ncbi.nlm.nih.gov/22320007


See also pages 1 and 68-72 in Adler, Peter  W. "Is Circumcision a Fraud?" Available online at https://www.lawschool.cornell.edu/research/JLPP/upload/Adler-et-al-final.pdf

By Ryan Jones 20 Jul, 2022
New Document Reveals Shortcomings in Circumcision Policy Development
circumcision fraud corruption
07 Feb, 2022
In September 2019, independent researcher Ryan Jones filed a FOIA request seeking a tabulation of all Medicaid spending on infant circumcision across participating states from the years 1999 - 2016. After more than two years of waiting, the request was finally fulfilled. The data is quite illuminating.
16 Feb, 2021
I was "circumcised" (preputially amputated) as a neonate in a US Naval hospital. I had troubles with erections and missed out on sexual functionality throughout my life. I did not realize that they were abnormal issues. It was only after I turned 35 and became a father of a boy that I learned better. My wife's OBGYN asked her the question "circumcise: yes or no?" She wrongly assumed that it was a good practice and went with "yes." However, she said so with a question along the lines of "shouldn't I?" Luckily someone later provided her with information when that OBGYN offered none. Today that OBGYN is the Chief Medical Officer at that hospital. These are not uncommon stories, as I have come to find out. Once I started researching how the normal/whole/intact/"uncircumcised" penis works and issues that fellow preputial amputees have experienced, I also realized that I had been living with the same issues. I simply did not know since I was practically born without my prepuce. People's genitals are not readily visible compared to other external body parts that an amputee may be missing. For instance, if someone is missing a hand, it's obvious that the person is missing out on functionality that the hand would provide. People rarely speak about the functions of the male prepuce. After speaking with fellow parents, it came very clear that it is not uncommon for medical professionals to not share such information before asking for consent to preputially amputate a boy. After looking at medical textbooks, medical diagrams and listening to medical professionals, it has become clear to me that many are left to believe that there is little to no value in the male prepuce. A recent survey was done by Intact America that found that 94% of hospitals ask parents and that the simple question often leads those parents to answer "yes." People appeal to the authority of medical professionals, just like my wife and I did. Due to these things, my wife, our two intact teen sons and I are compelled to educate others because, in part, we know that medical professionals and universities are not. Personally, finding ways to spread the information and to convince others to do the same, has become an all-consuming passion driven by my conscience. Unfortunately, the time and energy I spend doing so is not compensated. I have neglected my life-long career in corporate information technology, which has impacted my family's finances. Per historical documentation, it is a fact that the practice is born out of ritual and aimed to negatively affect the sexual activity of the individual. I do not understand how it was allowed for the story to change where much of the public is led to believe otherwise. The only possible explanation is greed and the desire to control.
27 Jan, 2021
"It quickly became apparent that what had just happened was a catastrophe... I died in 2015, not now." Lesley Roberts was stunned as she read the devastating final email from her beloved son Alex Hardy. The email had been timed to arrive on 25 November 2017, 12 hours after he killed himself. Less than an hour before the email arrived, Lesley had opened her front door to find a police officer standing there, explaining her son was dead. Alex was an intelligent and popular 23-year-old with no history of mental illness. Lesley could not understand why he would have wanted to take his own life. His email explained how the foreskin of his penis had been surgically removed two years before. This is commonly known as circumcision, but Alex had come to believe it should be regarded as "male genital mutilation". He never mentioned this to his family or friends when he was alive. Lesley did not even know her son had been circumcised. In the following months, she tried to find out more about circumcision. Why had it affected Alex so badly, and why did he feel killing himself was his only option?
19 Jan, 2021
By Laura M. Carpenter Male circumcision – the surgical removal of the foreskin of the penis – has long been a contested practice in Anglo‐American countries. Competing beliefs about pain as potentially redemptive and as essentially malign have fueled the controversy, with medical professionals and lay people alike debating whether circumcision causes or ameliorates physical or emotional pain, as well as how to respond to that pain. Because circumcision is a surgical intervention performed on bodies that are physiologically male, arguments about circumcision and pain have been indelibly shaped by changing cultural beliefs about boys, men and masculinity – beliefs which have informed approaches to circumcision and pain in turn. This study, which focuses on the period from 1960 to 2000 in the United States and Canada, examines how shifting understandings and enactments of masculinity, in concert with evolving practices in biomedicine, have transformed approaches to circumcision pain. My analysis centres on routine circumcision – the excision of the foreskin as a matter of course, for social, cultural or preventive health reasons, rather than as a religious observance or remedy for specific medical complaints. I examine the multiple ways in which pain is conceptualised and articulated, recognising that physical and emotional pain are inextricably intertwined (despite frequent efforts to differentiate them), and that separating them reinforces mind‐body dualism.1 To be sure, pain is just one of many factors that propel debate over male circumcision. Also contested are the questions of whether the practice protects or imperils health, whether it belongs under medical jurisdiction, whether it can be ethically consented to by parental proxy, and whether it exceeds the degree of religious and ethnic difference societies can tolerate (to name but a few possible issues). A thoroughgoing analysis of these and other broad battles waged around and through controversy over foreskin removal is, however, beyond the scope of this single article.2 Like other feminist scholars, I conceptualise gender not as universal or static, but rather as constructed through social processes and taking distinctive forms in different contexts.3 What ideals and norms are associated with masculinity and femininity and how they are enacted and regulated in particular places and periods influences myriad other aspects of social life, including medicalised cultural practices like male circumcision. Conversely, social and cultural practices influence gendered norms and behaviours in ways which hold possibilities for social change. Since the late 1800s, masculinity in Anglo‐America has, mostly – but not always – been associated with imperviousness to pain. Delineating the circumstances under which male pain is recognised, as well as what responses the recognition of boys’ and men's pain inspires, can open new ways to think about gender and sex and about the relief of human suffering. Read the rest of the article
16 Jan, 2021
My life has had its ups and downs. I can't say the same for my genital well-being. Here in the US, it appears that the doctors handling my circumcision case fudged my blood tests / rheumatology reports, and performed a contraindicated operation. I have since been diagnosed by one of California's most experienced urologists as having suffered almost every major physical trauma from the cut. As a kid growing up, my parents would often force me to wear underwear that was too loose, with the fly hole in the front, which often got caught on my genitals. Some days I was scared of even walking around like an average person. I sometimes urinated blood due to stenotic scarring. Likewise, I suffered skin tagging and miscellaneous abrasions all along my genitalia due to my sensitive skin issues. In adulthood, I was almost pronounced a eunuch in all but name. And the perpetrators got away scot-free. Nobody should be forced to go through the personal hell that I did.
15 Jan, 2021
Heather Hironimus, sitting with her attorney Thomas Hunker, breaks down as she signs consent for her 4-year-old son to be circumcised, during a May 22 hearing in Delray Beach, Fla. (AP)
15 Jan, 2021
For as long as I could remember I always had painful erections, and a penis that didn't look normal. Up until my early teens I didn't think about it to much. Other than the fact that I didn't like my penis. In my early teens I overhead a conversation that my circumcision was botched. That there were complications, they didn't do it right. They doctor even apologized to my parents. When confronting my parents about it they had nothing to say. No remorse or real reason. Just said I had it done cause its just the thing to do. From then on I carried the fact that my penis was abnormal, unpleasant, a mistake. I never embraced my sexuality. How could I ever please a woman? Is it even functional? Will it actually feel good? The older I got the more insecure. At the age of 18 I began to research circumcision. I accidentally stumbled into a foreskin restoration site. It seemed like a money grab so I ignored it. Later out of curiosity I went back to it. I read it thoroughly. I seen the pictures and I was convinced. I started restoration using a DTR and a retainer. Before long my painful erections were no more. Slowly, little by little, the damage had been repaired. Now fully healed I'm determined that my voice be heard. And a mother can reform from letting her son suffer the same fate.
14 Jan, 2021
William S. from Connecticut shares his story. Warning: Some may find this story disturbing. This is as much as I can recollect about being raped as a child. It was a day that stood out of my entire life. I was not at all sick. I was walking around fine. It started with I didn’t get a very big breakfast that day, they told me I had to do something later. They drove me to a place that was not my regular doctor. A different building. It was likely the hospital I was born and the fact they were bringing me back there joking about returning me if I misbehaved was disturbing in itself. I was truly feeling fine, why did they bring me here to the medical place?? I had already got my shots at the pediatrician. It was many years ago. But I remember this all far too vividly, walking into the building with apprehension. Despite my perpetual asking what this was, they still would not tell me what it was for. Only that it was something I “needed”. I was taken into a room, my (late, now deceased) parents were both there with me. At least my mom was there throughout it. Once it started my dad had turned away at some point and then left the room, I couldn’t see his face anymore. A bit of some drama, in the beginning a somewhat lady like man had trouble getting me into a restraint board device. I was already too big for it. My mom partially held my arms from behind me. It was a Circumstraint, a child, 4 quarters body restraint board. I was an immensely huge boy growing up. 11.+ lbs born, and when I was brought in for this I was walking, talking brilliant boy of possibly like around 2 year old. Give or take. I really do not know if it was way before, or somewhat after.. I do not have kids of my own. I knew only that I could walk, talk and had started to bathe on my own. Later on, By the start of kindergarten I was as big as a 2nd grader and read on a high school level. I was literate above all child standards. When this trauma happened my dad had stopped carrying me most of the time. He was older, 50s and I was that huge child.. After I was lifted up onto a cold table with something strange on it… The restraining was then done. I was held down totally, I couldn’t move at all. All I remember was my mom telling me to calm down. I was in a total panic. Asking why?? She still wouldn’t tell me the reason I was there only that it was “something boys had to get” Mom never ever failed to share technical details, she was a retired USAF flight instructor. After being held down for no idea how long, I had no clothing throughout this. I was cold, but I was sweating. I did not feel right, or safe, the first time I did not feel safe next to mom. I looked at her and she looked elsewhere. My heart started to pound out of my chest. My ears started ringing. I was dizzy for some reason. Maybe I had started a tantrum? I was beyond uncomfortable and would not stop asking why-why-WHY-why-WHY is this so? This person is NOT my Doctor! (I loved my regular pediatrician until I was 19 years old). As I yelled and questioned mom. She still wouldn’t say. That lady like man that was not my regular pediatrician was vigorously fondling my no-no parts, and I could not even lift my head up to see. That was just the tip of the horror. My mom told me to stay as still as I could. She even made a rather inappropriate comment about you better not jump around too much you don’t want him to mess it up. MESS WHAT UP? I DON’T WANT TO BE HERE!!! Then the pain started to hit me, intensely beyond any lifetime experience of pain even now decades later. I remember it searing through my body. I will never have any pain in my life that intense. In my adult life I’ve broken my neck, scraped my entire face up on 20 yards of gravel, broke two ribs, my foot, a finger. Been burned, sliced open, surgeries, Only a broken rib left me hunched over and barely able to move. The pain of what they were doing made stars flash dance in front of my eyes. My head was pounding like hammers going at the sides, top. I heard my heart pounding. It felt like my most sensitive boy part was mashed under something that weighed a thousand pounds. I wanted to swing and flail but I was totally restrained. Well, I learned after all the memories came resurfacing… a vital organ of mine was actually being crushed by hundreds of pounds of pressure in a circumcision clamp that I could not see. The most sensitive part of any baby boy’s anatomy, with over 20,000 nerve endings was being crushed inside a piece of metal designed to amputate 60-90% of a male’s nerve endings that have the greatest feeling. I was held there with my bundle of concentrated nerve endings being crushed for several minutes, as was the brutal cosmetic ritual I didn’t consent to. The pain at this point was beyond blunt drill bits being jammed into my body & mallets pounding my head. I would say white hot pain, but I’ve been burned by things white hot, you only hurt for a second and then you don’t. This pain, continued, and continued, and continued. I know I blacked out at several points from the screaming, or the shock my body had just gone into. I have vivid memories specked with periods of nothing. Feeling violated just scratches the surface of what was going on in my young brain. If they had used any anaesthetic, it didn’t do a god damn fucking thing. I felt every bit. Continued through this horrible genital pain I was being tortured and blade raped with, still mostly conscious. I likely went into shock, and lost blood. I remember there was blood all over. I have always been very outspoken, proud, independent, and strong, even as a toddler. I’m Swedish / Scandinavian / German, but born in Connecticut . I remember standing up and feeling very, very dizzy. The room was spinning. I felt as if my private parts had been smashed with a sledge hammer several times, then left under a bank safe. The pain was still immeasurable but it had changed intensity from a burning to a massive weight on my private part. My legs were shaking, my head spinning. My penis was still partially trapped under a bank safe, but I was walking. Sort of. I started to leave the room and go down a hallway. I was upset and determined to walk on my own and leave these people that had pretended to love me but taken me for this torture. I finally stopped, leaned up against the wall. Not moving. Building spinning. I could carry myself no longer. My dad picked me up and carried me out of the building. He was already in mediocre health. I feel strongly this was the last time in my life that my late father ever carried me. He died of a brain cancer when I was 24. The majority of the rest of the day there are no more memories. The next clear memory about the traumatic event was bath time. I don’t even know if it’s the same day or the mid day after. Several things about this are vivid, traumatic, as if they are on the best 4k 3D TV made. I was taking my clothes off at a bath my mother had drawn in a tub. My mom was across the hall in her bedroom. I was in the bathroom alone. I took the bandage off. My jaw dropped. WHAT DID THEY DO TO MY PENIS?? IT WAS NOT AT ALL THE SAME !? It did not even look like my fathers intact penis. I was so angry, shocked. There was a brief conversation. My asking her what was done, what, why, why, why did they change it? I had no complaints or problems. I didn’t say that I wanted that. Even at that age I knew it was wrong. Why did they hurt me, alter me? Thoughts bounced through my tiny head. My mom adamantly told me it was to protect me from things as I got older, what, you dont want to get problems later in life do you? It was preventative. Your penis could fall off if you didn’t have it. You’ll get penis cancer, you’ll get urinary tract infections. You’ll catch something. (These are lies). I said, but I don’t have problems yet, I said I don’t understand this and it hurts now. I want the Penis I had back. Fix it now. Take this action back. She told me that’s how it was going to be from now on. She acted like it was some sort of prize that I didn’t have to clean behind the foreskin anymore (she didn’t mention or likely know that I wont feel sex nearly as much, for life either). I remember in my first year or two of life prior to the cutting, mom was almost borderline obsessed with pull the foreskin back and clean it. I’ve since learned, on baby boys, do not ever retract the foreskin. Leave it until its comfortable for the owner of the skin to move it. Mom was taught very wrong by misinformed doctors and many are still misinformed to this day. Seriously it’s like America is still in 1948 with boy’s genitals. I think I started to get mad at her at that time & bury some very subconscious rage. I’m not sure at all, that may have been the beginning of a slow downfall of our mother-son relationship. I just don’t know. The feelings of being violated wouldn’t go away. As far as my penis, I didn’t know how I felt about that drastic change. I started to gradually lower myself into the bath water that day. It still felt like my part was trapped under a heavy safe but it was not ten tons as before. Just as if it had a massive weight crushing it. I could not touch it at all or pain would radiate through my entire body. I urinated on my own leg and the floor a couple times, that on its own felt as if I was urinating pure acid. I started gradually lowering myself into the bath, I was so very sore, worn out, so difficult to go slowly. My penis touched the water and it was as if I had put it into molten volcanic lava. The pain came back and radiated through my body like lightning waves of agony. I finally got myself into the water for a quick bath, got out, I passed out again. End of specific memories other than a “I’m glad its finally healed up” one. Buried deeply in corners of my brain for decades, yet still vivid. That’s the majority of the memories of my circumcision, or male genital mutilation, involuntary modification that I suffered. In one group, I’ve heard myself referred to as “a survivor”, it’s because there is an American baby boy fatality rate with this genital blade rape. That’s not something most mothers are ever informed of. The defects, the necessity of the organ, the times they mess it up. Its very vascular. The health issues happen 100% of the time to boys. They often do not tell the complications that will happen to parents. Some are severe, some are nuisance, some are not as severe. But EVERY SINGLE male its been done to in America and Israel has issues from a genital cutting. It is not done at all in Europe, they learned, circumcision harms. The difference in men is, the ones that don’t think they have issues have not read what its supposed to be like, naturally for an intact male. I thought until my late 30s that the painful erections with the skin way too tight were natural, how things were. Before she passed away, I yelled at my mom that she didn’t have the right to alter me and put me at unneeded risk of life and health as a baby.
By Elite Music Online 12 Dec, 2020
Circumcision is a Fraud ("CIAF") seeks to give voice to disenfranchised individuals and support people who wish to pursue their legal remedies. On this page is a list of cases being actively litigated.
More Posts
Share by: