HHS refers healthcare providers to federal investigators over pediatric gender care billing

The Department of Health and Human Services (HHS) has referred numerous hospitals, physician groups, pharmacies, and pharmacy benefit managers to federal investigators for potential billing irregularities regarding pediatric gender-related care. The referrals, made by HHS Secretary Robert F. Kennedy Jr. to the Office of Inspector General and by Vice President JD Vance to the Department of Justice, follow an HHS report titled ‘Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine.”’

The investigation focuses on insurance claims filed between 2015 and 2025, specifically targeting two diagnostic codes. HHS identified approximately $50 million in claims for puberty blockers billed under the code for ‘unspecified endocrine disorder’ for minors aged nine to 17, often without a corresponding diagnosis of gender dysphoria or precocious puberty. Additionally, nearly $11 million in claims were identified using the code for ‘precocious puberty’ for patients aged 13 to 17, a range the agency claims falls outside the appropriate diagnostic scope.

While the referrals mark a significant enforcement action targeting pediatric gender medicine, HHS noted that a referral is a request for investigation and does not constitute a formal charge of fraud. The agency stated that the identified coding patterns warrant scrutiny to determine if billing practices complied with federal regulations.