KEY TAKEAWAYS
- Vice President JD Vance referred findings from a Department of Health and Human Services report to Attorney General Todd Blanche and the DOJ for potential federal law violations
- The HHS investigation identified approximately $50 million in questionable insurance claims for puberty-blocking drugs billed under incorrect diagnostic codes
- Vance stated providers who intentionally miscoded treatments to secure insurance coverage for gender interventions “should go to prison”
- The report documented nearly $120 million in billed charges since 2019 for procedures involving minors, with treatment pathways reaching up to $170,000
Vice President JD Vance has escalated concerns over pediatric gender medicine billing practices by directly referring a damning federal investigation to the nation’s top law enforcement officials for potential criminal prosecution. The administration’s move signals zero tolerance for what officials describe as systematic insurance fraud targeting vulnerable minors.
Vance’s Referral and Statement
Vance referred findings from the Department of Health and Human Services report titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine'” to Attorney General Todd Blanche for immediate DOJ review. The vice president was unsparing in his assessment of the conduct.
“When providers miscode treatment in order to secure insurance coverage for gender-transitioning interventions that insurance would not otherwise cover, they should be held accountable,” Vance wrote. “If they have done so intentionally, thereby perpetrating a fraud on Medicaid or on private insurers, they should go to prison.”
Vance highlighted specific statistical anomalies from the HHS investigation as evidence of systematic fraud. “One study showed that only about 4.7 percent of patients diagnosed with ‘endocrine disorder, unspecified,’ had that actual condition,” Vance wrote. “Another notes a 30 percent increase in the number of endocrine disorder diagnoses, despite it being unlikely that there has been a substantial increase in pediatric endocrine disorders.”
HHS Investigation Findings
The comprehensive HHS report examined insurance coding and billing practices across more than 225 hospitals and health systems nationwide that established pediatric gender medicine programs. The investigation analyzed claims data spanning 2015 through 2025.
HHS identified approximately $50 million in claims for puberty-blocking drugs billed using the diagnostic code for “endocrine disorder, unspecified,” according to the report. The department also uncovered nearly $11 million in claims involving patients between 13 and 17 years old billed using precocious puberty diagnosis codes-codes that would typically be inappropriate for patients older than 13.
All-payer claims data revealed nearly $120 million in total billed charges since 2019 for related procedures involving minors. This figure included more than 5,500 surgical procedures and approximately 8,500 courses of hormones or puberty blockers.
🚨 WOW. It was just exposed by JD Vance and Robert F. Kennedy Jr. that hospitals who billed for child transgender operations cost up to $170,000 DOLLARS
For TOTALLY unnecessary and manipulation-induced operations.
The hospitals have now been referred to DOJ for federal law… pic.twitter.com/uosjPQGjYd
— Eric Daugherty (@EricLDaugh) August 13, 2026
The financial incentives underlying the alleged fraud proved substantial. HHS documented that average annual healthcare costs for a minor are approximately $3,000, while treatment pathways involving the interventions examined could reach approximately $75,000 without surgery and nearly $170,000 when surgery is included.
HHS Secretary’s Parallel Action
HHS Secretary Robert F. Kennedy Jr. separately referred a defined group of claims displaying potentially anomalous billing patterns to the HHS Inspector General. Those claims include puberty blockers paired with unspecified endocrine disorder diagnoses without accompanying gender dysphoria codes for patients between 9 and 17 years old.
The Inspector General referral also covers claims using precocious puberty codes for patients ages 13 through 17 and same-day cross-sex hormone prescriptions accompanied by primary gender dysphoria diagnoses in states restricting those treatments for minors.
Clear Message to Providers
Vance emphasized the administration’s resolve to eliminate what officials view as exploitative practices. “Rather than allow the proliferation of harmful, sex-rejecting procedures on our children, we must send a clear message that any hospitals and providers that have participated in these practices will face justice,” Vance wrote.
The referral follows the Trump administration’s earlier decision to end federal Medicaid and Children’s Health Insurance Program funding for the procedures involving minors, marking a coordinated enforcement strategy across multiple government agencies.
The Justice Department has not publicly announced whether it will open criminal investigations or pursue prosecutions based on Vance’s referral. Attorney General Blanche’s office has not yet commented on the administration’s request.
Fox News Digital / CelebBNews contributed to this report.