Vice President JD Vance has sent a newly released Department of Health and Human Services report to the Justice Department, seeking review of possible federal law violations connected to pediatric gender medicine and questionable insurance billing.

The findings paint an alarming picture of medical institutions turning vulnerable children into lucrative customers.

The report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine,’” examines coding practices involving puberty blockers, cross sex hormones, and surgical procedures provided to minors.

Its conclusions raise serious questions about whether providers manipulated diagnoses to secure insurance payments.

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According to HHS materials, more than 225 hospitals and health systems created pediatric gender programs.

Insurance claims collected nationwide between 2015 and 2025 identified roughly $50 million in puberty blocker claims billed under the diagnosis of “endocrine disorder, unspecified.”

Another nearly $11 million involved claims for patients between 13 and 17 that used a precocious puberty diagnosis.

The report notes that such a diagnosis is generally inappropriate for patients older than 13, making those billing patterns especially ripe for investigation.

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All payer claims data also showed nearly $120 million in billed charges since 2019 for procedures and treatments involving minors.

Those claims included more than 5,500 surgical procedures and approximately 8,500 courses of hormones or puberty blockers.

HHS Secretary Robert F. Kennedy Jr. referred a specific group of suspicious claims to the HHS Inspector General.

Those cases included puberty blocker claims paired with unspecified endocrine diagnoses but lacking codes for gender dysphoria or precocious puberty among patients from 9 through 17.

Investigators also flagged claims using precocious puberty codes for teenagers from 13 through 17.

Other concerns involved same day cross sex hormone prescriptions in states that restrict such treatment for minors, along with billing patterns involving affiliated medical providers.

The report relied on peer reviewed research, hospital records, whistleblower testimony, insurance claims analysis, and interviews with patients and parents.

That broad collection of evidence suggests this was not merely a paperwork mix up that can be dismissed with bureaucratic excuses.

The financial incentives identified in the report are staggering.

While average annual health care expenses for a minor are about $3,000, treatment pathways involving these interventions can climb to $75,000 without surgery and nearly $170,000 when surgery is included.

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Those treatment tracks can also generate continuing revenue through prescriptions, monitoring, and follow up care that may last for years.

For large hospital systems, that means children can become long term revenue streams while insurers and taxpayers are left holding the bill.

In a letter to Attorney General Todd Blanche, Vance highlighted evidence suggesting that unspecified endocrine diagnoses were being used far beyond their legitimate medical purpose.

He wrote, “One study showed that only about 4.7 percent of patients diagnosed with ‘endocrine disorder, unspecified,’ had that actual condition.

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.”

Vance argued that providers who intentionally coded treatments incorrectly to obtain coverage should face criminal consequences.

He made clear that deliberate fraud against Medicaid or private insurers should not result in a mild reprimand from some hospital compliance office, but could warrant prison.

The vice president also called for justice against hospitals and providers that participated in harmful procedures involving children.

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His referral gives federal investigators an opening to determine whether ideological medicine was supported by fraudulent billing, potentially at enormous public expense.

The action follows the Trump administration’s decision to end federal Medicaid and Children’s Health Insurance Program funding for these procedures on minors.

Kennedy and other HHS officials have said the findings demand deeper scrutiny of financial incentives, billing practices, patient safety, and program integrity.

The Justice Department had not publicly commented on the referral at the time of the report.

Still, Vance has placed the evidence directly before federal prosecutors, and hospitals involved in these billing patterns may soon discover that creative coding carries consequences beyond another government audit.

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