Vice President JD Vance Calls for DOJ Probe into Alleged Fraudulent Billing for Gender-Affirming Care

On August 13, Vice President JD Vance, head of the White House Anti-Fraud Task Force, sent a letter to Acting Attorney General Todd Blanche referring the HHS report “Wolves in White Coats” to the Justice Department for investigation. The report alleges that dozens of hospitals, clinics and pharmacies billed insurers for gender-affirming treatments for minors using codes for “unspecified endocrine or hormone-related disorder” or “early/precocious puberty” instead of gender dysphoria. Vance framed the referral as part of the administration’s twin priorities of curbing health-care fraud and restricting gender-affirming care for youths.

The HillThe AdvocatePoliticoNew York PostPink NewsReutersVance seeks criminal investigation into hospitals doing child sex changes, citing evidence of fraud

The request follows a Trump-era rule barring Medicaid and CHIP from covering puberty blockers, hormone therapy or surgeries for minors. The rule, previously blocked by a court, is slated to take effect on October 13. The HHS report was released two days after CMS cut Medicaid funding to hospitals offering such care. The administration cites more than $5.7 billion recovered from Medicare Advantage fraud in 2023.

Politico

• HHS cited nearly $120 million in claims for gender-affirming services to patients aged 9-17 since 2019.

Reuters

• The Hill’s summary identified ? $50 million in puberty-blocker claims under an “unspecified endocrine” code and ? $11 million under “early puberty.”

Politico

• Claims span a nationwide database (2015-2025); over 30 facilities used non-specific hormone-disorder codes.

Politico

• Highlighted institutions: Mount Sinai Medical Center (? $8.2 million) and Boston Children’s Hospital (? $6.5 million).

New York Post

• The American Medical Association affirmed support for gender-affirming care and called the CMS rule “baseless.”

Politico

• The Justice Department declined comment on the pending investigation.

New York Post

Medical and LGBTQ+ groups dispute the report’s methodology. The Human Rights Campaign called the HHS panel “hand-picked anti-transgender activists.” The American Academy of Pediatrics and the AMA argue the report conflates coding errors with fraud and that major medical bodies back gender-affirming care for minors.

The Advocate

HHS identified nearly $120 million in claims, while the Hill’s summary totals ? $61 million for specific codes. The report does not determine whether coding discrepancies constitute intentional fraud.

Politico

• “Some pediatric gender clinics and children’s hospitals have apparently used misleading or even fraudulent diagnostic and billing codes to ensure that insurance companies will cover the procedures,” — Vice President Vance

The Hill

• “You cannot hand-pick a panel of anti-transgender activists, feed it research from anti-trans advocacy organizations, publish the result under an HHS banner, and call that independent science,” — HRC President Kelley Robinson

The Advocate

The Justice Department’s decision on a criminal investigation is pending. If opened, the probe could lead to civil or criminal penalties. Medicaid and CHIP restrictions remain scheduled for October 13, though legal challenges may delay implementation. Stakeholders are expected to continue lobbying as the anti-fraud and gender-care policies intersect.

New York Post