HHS flags hospitals for improper billing in gender care for minors

The U.S. Department of Health and Human Services (HHS) has accused dozens of hospitals and healthcare providers of improperly billing for gender-affirming care provided to minors. The agency has referred the matter to its Office of Inspector General and the Justice Department for investigation.

In a report titled "Wolves in White Coats," HHS alleged that some gender-related treatments were billed under unspecified conditions or based on diagnoses of early puberty. The report claims providers billed for therapies for minors aged 9 to 17, documenting endocrine or hormone-related disorder diagnoses rather than gender dysphoria.

According to HHS, these alleged inaccurate diagnoses resulted in payments from both private and government-sponsored health plans. The agency 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 data from the conservative medical advocacy organization Do No Harm, HHS said hospitals and clinics billed nearly $120 million for services provided to minors since 2019. The report named Mount Sinai Hospital in New York City and Boston Children's Hospital among the top billing providers.

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

A spokesperson for the American Hospital Association declined to comment on the report. Mount Sinai did not respond in time to a request for comment, while a spokesperson for Boston Children's Hospital said it is reviewing the report.

The development follows a rule finalized this week by the Trump administration barring two major federal health programs from funding puberty blockers, hormone therapy, and surgeries to treat gender dysphoria.