I would like to ask for experiences regarding out of home state surgery being funded by home state Medicaid insurance.  We are in North Carolina and while we have access to very good medical care, none of our urology centers meet the guidlines set in the CAH concensous statement to perform her vaginoplasty.

 We have contacted the most reccomended (by the Cares Foundation) centers and been told that they would not accept our states Medicaid.  Our state recognizes that we should go out of state because of the now accepted guidlines and has provisions  to allow Medicaid to fund this.  The problem has been finding a center that is both qualified and willing to file the paperwork needed to ensure their payment.

I guess what I am asking is has someone been in this position and if they overcame it, how.  We would like the best for our daughter which entails the best surgical center we can get to accept us.  If someone affiliated with a center or facility that meets the accepted guidlines happens to read this,  please let me know from your perspective what the best course would be. 

As an aside, please don’t use this posting as a spring board for rants against surgery, as this is not cosmetic surgery.  We have thought long and hard and done an extensive amount of research before making our decision.  We are just looking for helpful advice on how to provide the most competent care available for our daughter.