HHS report alleges fraudulent billing in gender medicine

The U.S. Department of Health and Human Services (HHS) has released a report titled ‘Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of Gender Medicine.’ The report examines insurance coding practices and alleges that some providers used misleading diagnostic codes, such as ‘precocious puberty,’ to secure coverage for medical transition procedures for minors.

Among the more than 200 healthcare providers named in the report is UChicago Medicine. The report alleges that UChicago Medicine used potentially fraudulent codes to bill for puberty blockers for patients aged 13 to 17. While the report claims approximately 300 patients across various providers were improperly diagnosed to facilitate coverage, it does not provide specific evidence to support the allegations or confirm the transgender status of the patients involved.

In conjunction with these findings, HHS announced a final rule ending the use of federal Medicaid and CHIP funds for medical transition procedures for patients under 19, effective October 13. For those currently on hormone therapy, a six-month taper period will be permitted. HHS stated the decision follows a review identifying significant evidence gaps and safety concerns regarding these interventions for children.