HHS Report Alleges Widespread Billing Fraud in Pediatric Gender-Affirming Care

A new report from the U.S. Department of Health and Human Services (HHS) alleges that medical providers and hospitals utilized inaccurate billing codes to secure insurance coverage for pediatric gender-affirming treatments. The 64-page document, titled "Wolves in White Coats," examines insurance claims filed between 2015 and 2025, asserting that providers intentionally mislabeled procedures to bypass insurance restrictions.

According to the findings, nearly $50 million in claims for puberty blockers were submitted using codes for unspecified endocrine disorders rather than gender dysphoria. The report further identifies approximately $11 million in claims billed under "precocious puberty" codes, a diagnosis the agency notes is clinically inapplicable to teenagers. HHS officials suggest that providers were guided by external resources that recommended specific coding strategies to increase the likelihood of reimbursement for treatments that might otherwise be rejected by insurers.

Medicaid and other government programs reportedly covered a portion of these claims, with the report highlighting that approximately $8 million of the endocrine-coded charges were paid through Medicaid. The agency argues that these practices obscured the nature of the medical services provided to minors, raising concerns regarding the transparency and medical necessity of the billing processes used for these procedures.