SAN FRANCISCO (AP) — A U.S. Department of Health and Human Services review board says transgender people receiving Medicare may no longer be automatically denied coverage for sex reassignment surgeries.

The agency’s Departmental Appeals Board ruled Friday that a three-decade-old policy excluding such surgeries from the treatments that can be covered by the national health program for the elderly and disabled is no longer justified.

The decision came in response to an administrative challenge brought last year by Denee Mallon, a 74-year-old Army veteran in New Mexico who in 2012 sought to have Medicare pay for her genital reconstruction surgery and was denied.

Jennifer Levi, a lawyer with Gay & Lesbian Advocates and Defenders in Boston, says the lifting of the coverage ban means Medicare recipients will be able to seek authorization for sex-reassignment surgery with a doctor’s recommendation