Vance Seeks DOJ Probe of 30-Plus Providers Over Puberty Blocker Billing Codes

2 articles · Updated · POLITICO · Aug 13

More than 30 hospitals, clinics and pharmacies billed puberty blockers under non-specific hormone-disorder diagnoses, according to an HHS report Vance referred to the Justice Department on Thursday.
The report says providers used endocrine-disorder and precocious-puberty codes instead of gender-related diagnoses, a pattern its authors say could have helped secure insurance coverage and may indicate fraud.
The Justice Department said it received the referral and will review it carefully, noting it has already reached settlements with major hospital systems over false billing tied to gender-affirming care for minors.
Whether the coding reflects fraud or mistakes remains unclear, but the case fits a broader federal focus on diagnosis-code abuse after DOJ announced $5.7 billion in health-fraud recoveries in January.