Vice President J.D. Vance is asking federal investigators to examine hospitals and clinics providing transgender-related medical care to minors after a new Department of Health and Human Services report alleged that providers may have used inaccurate billing codes to obtain insurance coverage for treatments.
Vance announced Thursday that facilities identified by the HHS review had been referred to the Justice Department and the HHS Office of Inspector General for possible violations of federal law.
The allegations center not simply on the controversial medical procedures themselves, but on how hospitals and other providers allegedly described patients’ diagnoses when billing Medicaid and private insurers.
Vance pointed to the newly released report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” calling its allegations “deeply disturbing.”
“For years now, some hospitals and healthcare providers have been subjecting children to horrific, experimental treatments in service of radical gender ideologies,” Vance wrote.
He also alleged that financial incentives played a role.
“It turns out that convincing vulnerable children to reject their gender can create patients for life, earning hospitals tens of thousands of dollars in additional revenue per child,” he said.
For years now, some hospitals and healthcare providers have been subjecting children to horrific, experimental treatments in service of radical gender ideologies. Today, thanks to the Wolves in White Coats report released by @HHSGov, we know why: profit. It turns out that… pic.twitter.com/B7K7iumpYC
— JD Vance (@JDVance) August 13, 2026
According to HHS, approximately 225 hospitals established pediatric gender programs. The department’s report examines insurance claims and alleges that some providers may have used diagnostic codes that enabled treatments to receive coverage when insurers otherwise might not have paid for them.
“More than just pushing these procedures on kids, hospitals and providers may have been defrauding Medicaid and private insurers by using misleading or fraudulent billing codes to get insurance to cover the costs,” Vance said.
HHS Secretary Robert F. Kennedy Jr. said the findings warrant further scrutiny.
“The findings raise serious questions about what families were told, what insurers were told, and how these procedures were billed,” Kennedy said.
“Doctors and hospitals must put children’s health ahead of ideology and financial gain,” he continued. “This report identifies troubling billing practices that demand scrutiny.”
One billing category is receiving particular attention.
In his referral letter to Attorney General Todd Blanche, Vance alleged that some pediatric gender clinics and children’s hospitals used diagnoses such as “endocrine disorder, unspecified” when submitting insurance claims.
“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,” Vance wrote.
He cited research indicating that only 4.7 percent of patients assigned that diagnosis actually had the underlying condition. Vance also pointed to another study showing a roughly 30 percent increase in endocrine-disorder diagnoses, arguing that the increase warrants examination.
“This miscoding has allowed hospitals to bill insurance companies tens of millions of dollars for medications like puberty-blocking drugs,” Vance told Blanche.
Politico reported that HHS analyzed claims from a nationwide database covering 2015 through 2025. According to that analysis, public and private insurers were billed nearly $50 million for puberty-blocking drugs prescribed to patients between 9 and 17 who had an endocrine-disorder diagnosis.
That figure does not by itself establish fraud. Medical billing frequently involves complicated diagnostic and treatment codes, and determining whether a particular claim was intentionally false requires examining the patient’s medical record, the applicable coding rules and what the provider knew when submitting the claim.
That is now the question federal investigators are being asked to examine.
This Administration will not stand idly by while some in the medical community harm our children in search of profit. That is why today I am referring this matter to the Department of Justice to launch a federal criminal investigation. We will stop this fraud and restore trust in… pic.twitter.com/FCAsl4wpY4
— JD Vance (@JDVance) August 13, 2026
Vance made clear that the referral is not itself a finding that the hospitals committed crimes.
“Today, Secretary Kennedy and I referred hospitals and clinics identified by this review to the Department of Justice and the HHS inspector general for possible violations of federal law,” he said. “These allegations are crazy, and they demand investigation.”
The administration’s scrutiny comes amid a broader effort to restrict transgender-related medical interventions for minors.
Politico noted that the HHS report arrived two days after the Centers for Medicare and Medicaid Services cut Medicaid funding to hospitals offering such procedures to minors. A federal judge had previously blocked a CMS rule that would have withheld both Medicare and Medicaid funding from hospitals providing the care.
Health care fraud is already a major enforcement area for the federal government. The Justice Department announced in January that it had recovered more than $5.7 billion in health care fraud cases, including matters involving unsupported or invalid diagnosis codes.
The new referrals could determine whether the coding practices described by HHS belong in that category.
