The House Oversight and Accountability Committee is investigating whistleblower allegations of fraudulent billing to the Medicaid program for pediatric gender reassignment care, including at Texas Children’s Hospital (TCH) in Houston.
In letters sent to the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS), committee members expressed concern that TCH providers were falsifying diagnosis codes for patients seeking gender transition care not covered by Medicaid.
“We understand that TCH providers, in their efforts to secure Medicaid coverage for gender reassignment treatments, appear to have fraudulently diagnosed biologically female patients with testosterone deficiency and hypogonadism in order to gain Medicaid approval for testosterone treatments that would have been denied under Texas Medicaid regulations if prescribed for the purpose of gender reassignment,” alleges the letter, signed by Government Operations and Federal Workforce Subcommittee Chairman Pete Sessions (R-Texas) and Health Care and Financial Services Subcommittee Chair Lisa McClain (R-Mich.).
Committee members also expressed concern about the perception that the Biden administration is prioritizing action against individuals who have made allegations.
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Texas surgeon general, Dr. Eisan Haim, is photographed in front of the U.S. Capitol. (Getty Images)
Dr. Eisan Haim, a Texas surgeon whose training included attending TCH during the period in question, is facing four federal charges of allegedly violating the Health Insurance Portability and Accountability Act (HIPAA) for releasing redacted documents that appeared to expose the hospital’s pedophile care program’s continuation after the public was told such practices had been discontinued.
The U.S. Attorney’s Office for the Southern District of Texas alleges that Dr. Heim obtained patient information from Texas Children’s Hospital’s electronic systems without authorization.
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“He allegedly obtained this information under false pretenses and with the intent to maliciously harm TCH,” according to federal prosecutors.
Jury selection for Dr. Heim’s trial is scheduled for August 20th.
Dr. Eisan Haim leaves the Bob Casey Federal Courthouse after appearing for an arraignment hearing in Houston, Monday, June 17, 2024. Haim, a self-described whistleblower on transgender medical care for minors, is charged with federal charges of illegally obtaining personal information of patients not under his care with intent to harm the nation’s largest children’s hospital. He has pleaded not guilty. (Yi-Ching Li/Houston Chronicle via Getty Images)
“If they can go after me as a whistleblower, they can go after you,” Dr. Heim told Fox News. “So we have to take it to court and win.”
Judges Sessions and McClain argued that Dr. Heim’s treatment could intimidate future whistleblowers, writing in their letters to HHS and CMS that “potential whistleblowers seeking to report Medicaid fraud or other illegal conduct appear to have been warned that the federal government will target individuals seeking to report hospital misconduct and turn a blind eye to the Medicaid fraud and other hospital wrongdoing they seek to report.”
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The Committee is currently requesting documents, correspondence, and staff-level briefings to learn about ongoing audits and investigations into fraudulent Medicaid claims related to gender transition care.
The Centers for Medicare and Medicaid Services told Fox News that “CMS has received the letter and will respond to members of Congress.”
Texas Children’s Hospital has closed two medical centers serving low-income families in Greenspoint and Southwest Houston. The center, pictured, at 9700 Bissonette Avenue in Southwest Houston, will close on June 30, 2024. (Jill Karnicki/Houston Chronicle via Getty Images)
The Office of Inspector General at the Department of Health and Human Services also acknowledged the inquiries from the lawmakers, telling Fox News, “We have received the letter and are currently reviewing it.”
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Texas Children’s Hospital did not respond to Fox News’ request for comment.
