Court Vacates Gender Identity Provisions in Section 1557 Nondiscrimination Rule
On October 22, 2025, the U.S. District Court for the Southern District of Mississippi vacated portions of CMS's May 2024 Section 1557 nondiscrimination rule that expanded Title IX's definition of sex discrimination to include gender identity discrimination. The vacated provisions are legally void nationwide. All other provisions of the Section 1557 final rule remain in effect. This decision affects how Medicaid managed care plans must comply with federal nondiscrimination requirements related to gender identity in coverage decisions, utilization management, and member communications.
Medicaid MCOs must immediately review and potentially revise policies, coverage criteria, and training materials that rely on the now-vacated gender identity protections under Section 1557.
Managed Care
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