Senator JD Vance has asked the Justice Department to investigate hospitals and clinics for potentially fraudulent billing practices related to transgender care for minors. A report alleges that providers may have used incorrect diagnosis codes to justify prescriptions for puberty blockers, potentially violating federal law.
The investigation into billing practices for transgender care for minors could lead to legal repercussions for healthcare providers and further restrict access to gender-affirming treatments for young people, reflecting ongoing political and legal battles over such care.
Senator JD Vance has urged the Justice Department to investigate hospitals and clinics for potentially fraudulent billing practices related to gender-affirming care for minors. A report cited by Vance alleges that healthcare providers have used incorrect diagnosis codes, such as those for endocrine disorders or 'precocious puberty,' as a proxy to justify the prescription of puberty blockers.
The report's authors claim this miscoding is done to ensure procedures are covered by insurance. An analysis by HHS reportedly found that more than 30 hospitals, clinics, and pharmacies nationwide billed for puberty-blocking drugs using non-specific hormone disorder diagnoses. Vance stated he referred the full report to the Justice Department to determine if federal laws, regulations, or policies were violated.
Incorrect diagnosis coding is a known issue in healthcare, though it remains unclear if the errors highlighted in the report were intentional fraud or simple mistakes. The Justice Department has pursued investigations into health systems and insurers for such coding errors in the past, contributing to significant health fraud recoveries. This referral is part of a broader effort by the Trump administration to restrict gender-affirming care for minors.
In parallel, CMS recently finalized a rule to cut Medicaid and Children's Health Insurance Program funding for gender-affirming care for minors, citing a lack of sufficient clinical data. A previous attempt by CMS to remove healthcare providers performing such procedures on minors from Medicare and Medicaid programs was blocked by a federal court.