HHS report alleges fraudulent coding in pediatric gender medicine

The 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 alleges that pediatric gender clinics and hospitals may have utilized misleading or potentially fraudulent diagnostic and procedural codes to secure insurance coverage for puberty blockers, cross-sex hormones, and surgeries on minors.

HHS suggests that diagnoses such as unspecified endocrine disorders and precocious puberty may have been used to increase the likelihood of reimbursement. The report notes that pediatric gender programs expanded from a few specialized clinics to over 225 hospitals and health systems nationwide by the early 2020s. It describes a ‘captive patient’ dynamic, where treatments create long-term revenue streams through continuous medication, testing, and specialist visits.

According to the report, there are estimates of nearly $120 million in submitted charges involving minors since 2019. Additionally, the report criticizes federal policy, stating the Biden Administration promoted access to these procedures through civil rights enforcement and funding policies, while the Justice Department challenged state-level restrictions.