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Medical Daily
Medical Daily
Joseph James

HHS Refers Hospitals, Pharmacies and Benefit Managers to Federal Investigators Over Youth Gender Care Billing Codes

The Department of Health and Human Services referred scores of hospitals, physician groups, pharmacies, and pharmacy benefit managers to federal investigators over insurance claims filed for gender related care in minors. The referrals, announced on August 13, name some of the largest health systems in the country and mark the widest enforcement action yet in an ongoing federal effort targeting pediatric gender medicine.

A referral is not a charge. It is a request that investigators look, and the distinction matters for anyone reading a hospital's name on the list. HHS Secretary Robert F. Kennedy Jr. referred organizations to the department's Office of Inspector General, while Vice President JD Vance, who chairs a White House anti-fraud task force, referred entities to the Justice Department. The HHS referral letter to the Inspector General describes the claims as showing "potentially anomalous billing patterns."

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