Trump administration accuses hospitals of improper billing over gender care for minors

By Amina Niasse

NEW YORK, Aug 13 (Reuters) – The U.S. Department of Health and Human Services accused dozens of hospitals and healthcare providers on Thursday of improperly billing for gender-affirming care and referred them to the Office of Inspector General and the Justice Department for investigation.

HHS released a report titled “Wolves in White Coats” that argued some gender-related treatments were paid for under unspecified conditions or, in some cases, based on diagnoses of early puberty. The report includes contributors who have been critical of gender-affirming care.

HHS said the providers billed for the therapies to treat minors aged 9 to 17, documenting an unspecified endocrine or hormone-related disorder diagnosis rather than gender dysphoria. The report alleged inaccurate diagnoses resulted in payments from both private and government-sponsored health plans. 

HHS said that as gender care for minors has grown, it has become a larger revenue source for hospitals, creating financial incentives for more frequent billing. Citing conservative medical advocacy organization Do No Harm, the agency said hospitals and clinics billed nearly $120 million for the services provided to minors since 2019. 

Gender-affirming care for minors can include clinical counseling, puberty blockers or hormone therapy. Advocates for transgender minors say the services can reduce mental distress and support social wellbeing.

Do No Harm has legally challenged gender-affirming care and diversity, equity, and inclusion programs in healthcare.

A spokesperson for the American Hospital Association declined to comment on the report.

The Trump administration finalized a rule this week barring two major federal health programs from funding puberty blockers, hormone therapy and surgeries to treat gender dysphoria, which is distress from a mismatch between a patient’s sex at birth and gender identity. 

HHS, based on Do No Harm data, named Mount Sinai Hospital, based in New York City, and Boston Children’s Hospital as some of the top billing providers of the services for minors. 

“In an era of razor-thin pediatric margins and pressure on hospital reimbursements, this new patient cohort — young, insured or Medicaid-eligible, and requiring perpetual follow-ups — represented a strategic area of growth,” the report said.

Mount Sinai did not respond in time to a request for comment. A spokesperson for Boston Children’s Hospital said it is reviewing the report.

(Reporting by Amina NiasseEditing by Rod Nickel)