WASHINGTON — Vice President JD Vance has referred findings from a new Department of Health and Human Services report to Attorney General Todd Blanche and the Department of Justice, asking federal authorities to examine whether certain medical providers intentionally violated federal law through alleged insurance-billing practices involving treatments for minors.
The referral centers on an HHS report titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited From the Fraud of ‘Gender Medicine.’” The document examines billing and insurance claims associated with pediatric gender-medicine programs, including claims involving puberty blockers and cross-sex hormones.
According to HHS, more than 225 hospitals and health systems established pediatric gender programs across the United States. The department’s analysis of nationwide insurance claims from 2015 through 2025 identified roughly $50 million in claims for puberty-blocking drugs that were billed using an “endocrine disorder, unspecified” diagnosis.
HHS also identified nearly $11 million in claims involving patients ages 13 to 17 that used a diagnosis code associated with precocious puberty. The department argued that such a diagnosis would generally be inappropriate for patients above age 13.
Additional all-payer claims data cited by HHS identified approximately $120 million in billed charges since 2019 for procedures involving minors, including more than 5,500 surgical procedures and about 8,500 courses of hormones or puberty blockers.
The report does not establish that all of those claims were fraudulent. Instead, HHS has identified specific patterns it considers potentially anomalous and referred a defined group of claims to the department’s inspector general for further examination.
Among the cases flagged are claims involving puberty blockers paired with unspecified endocrine-disorder diagnoses without corresponding codes for gender dysphoria or precocious puberty. HHS also identified certain claims involving older adolescents and treatments provided in states where such interventions for minors are restricted.
In his letter to Blanche, Vance argued that intentional misrepresentation of medical information to obtain insurance reimbursement could constitute fraud.
“When providers miscode treatment in order to secure insurance coverage,” Vance wrote, “they should be held accountable.” He added that providers who intentionally defraud Medicaid or private insurers should face criminal consequences.
HHS Secretary Robert F. Kennedy Jr. has separately directed the department’s inspector general to review claims displaying what officials described as unusual billing patterns.
The administration has also taken steps to restrict federal Medicaid and Children’s Health Insurance Program funding for certain gender-related procedures involving minors, reflecting its broader policy opposition to such treatments.
The Justice Department has not announced whether it will open criminal investigations or pursue prosecutions as a result of Vance’s referral.
For now, the allegations remain subject to federal review. Any criminal charges would require investigators to establish that specific individuals knowingly engaged in unlawful conduct rather than relying solely on unusual billing patterns.
Vance’s referral nevertheless represents a significant escalation in the administration’s scrutiny of pediatric gender medicine, placing potentially fraudulent billing practices directly before the nation’s top federal law-enforcement authorities.
