Hospitals Allegedly Misusing Diagnosis Codes for Minor Treatments
According to a recent report from the Department of Health and Human Services (HHS), there are suspicions that hospitals have been inaccurately using diagnosis codes to bill insurance for puberty blockers and other gender transition medications given to minors.
The report, titled “Wolves in White Coats: How Doctors and Hospitals Promoted and Profited from the ‘Gendered Medicine’ Fraud,” reveals that over 225 hospitals and health systems across the country have set up pediatric gender programs. As a result of these findings, HHS has referred the case to the Office of Inspector General to investigate potential violations of federal law.
Vice President J.D. Vance connected this alleged scheme to financial motivations, suggesting that it revolves around profit. He stated, “For years, some hospitals and health care providers have subjected children to horrific experimental treatments because of radical gender ideology. Today, thanks to the Wolf in White Coat report released by @HHSGov, we know why: For profit. We found that convincing vulnerable children to reject their gender can create lifelong patients and provide hospitals with tens of thousands of dollars in additional revenue per child.”
Vance suggested that these healthcare providers may have misled Medicaid and private insurers using deceptive billing codes to cover treatment expenses.
It appears that providers are submitting bills for puberty blockers under common hormone disorder codes, specifically E34.9, which refers to “endocrine disease, unspecified.” This code does not properly account for gender dysphoria.
The report indicates that claims related to puberty blockers, filed this way for patients aged 9 to 17 between 2015 and 2025, amounted to around $50 million. Additionally, nearly $11 million was claimed for patients aged 13 to 17 under an improper diagnosis for “precocious puberty,” which applies to children entering puberty unusually early.
However, the report cautions that these figures serve more as an indication rather than definitive findings and suggest they should be compared against actual patient records.
Leading the charge is Vice President Vance, who heads the White House Task Force on Fraud. He has submitted the complete report to Attorney General Todd Blanche for review, arguing that healthcare providers who mismanaged treatments should face consequences. He emphasized further, stating, “If they did this intentionally and thereby defrauded Medicaid and private insurance companies, they should be sent to prison.”
The report touches on specific types of providers involved. For instance, a profile in a major publication highlighted Dr. Sidveh Gallagher, a Miami surgeon who performs chest surgeries for teenagers. Dr. Gallagher mentioned she operates on about 40 patients per month, with a couple being minors, and has treated children as young as 13 or 14. Although her work contradicts Florida Department of Health guidelines, it’s not explicitly illegal, and there’s no evidence of her carrying out surgeries without parental approval.
Meanwhile, the Centers for Medicare and Medicaid Services has ceased federal funding for gender reassignment procedures for minors through the Medicaid Children’s Health Insurance Program. This follows a resolution in May in which Texas Children’s Hospital agreed to a $10 million settlement concerning allegations of using incorrect diagnosis codes for certain interventions.
The report has already triggered a swift reaction online, with discussions proliferating across social media platforms.
