Vice President JD Vance has criminally referred hundreds of hospitals and health systems to the Department of Justice and HHS Inspector General for potential violations of federal law following an explosive report by the U.S. Department of Health and Human Services (HHS).
The HHS released “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” which alleges that hospitals intentionally misdiagnosed children with “gender dysphoria” to bill private insurers and Medicaid for puberty blockers, cross-sex hormones, and gender-affirming surgeries. The report states healthcare providers abused diagnostic codes—specifically using endocrine disorder code E34.9 instead of gender-related diagnoses—to fraudulently secure coverage for treatments that cost patients an average of $75,000 without surgery and nearly $170,000 with procedures.
According to HHS data, over 225 hospitals established pediatric gender programs nationwide between 2015 and 2025, generating approximately $50 million in insurance claims using the misdiagnosed code. The report cites peer-reviewed research showing only 4.7 percent of patients labeled with “endocrine disorder, unspecified” actually had the condition, while a separate study noted a 30 percent surge in such diagnoses despite minimal evidence of increased pediatric endocrine disorders.
In a letter to Attorney General Todd Blanche, Vance detailed that providers deliberately misused billing codes to compel insurance coverage for gender-transitioning interventions. “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,” he wrote. “If they have done so intentionally, thereby perpetrating a fraud on Medicaid or private insurers, they should go to prison.”
Vance’s referral follows the HHS report’s conclusion that hospitals and providers exploited vulnerable children by creating lifelong medical dependencies through fraudulent billing practices. The report includes accounts of minors subjected to experimental treatments without adequate oversight, including a homeless child who began hormone therapy at age six and later became homeless after detransitioning.
The Department of Justice is now tasked with investigating whether hospitals violated federal law, regulations, or policies including the False Claims Act and fraud statutes. Vance emphasized that “any hospitals and providers that have participated in these practices will face justice.”
