Kathmandu— United States hospitals have billed nearly $120 million for gender-affirming surgeries and hormone treatments administered to minors since 2019, according to a recent report released by the Department of Health and Human Services (HHS). The ‘Wolves in White Coats’ report cites watchdog research indicating that some providers may have utilized misleading billing codes to secure insurance coverage for these interventions. HHS has referred hospitals and clinics identified in the report to the Department of Justice and its own investigators, citing observed billing patterns requiring further scrutiny.

Billing Irregularities Identified

The HHS report details approximately $50 million in claims for puberty blockers administered to children aged nine to 17. These claims reportedly used a general hormone-disorder code without an accompanying gender-related or early-puberty diagnosis on the same claim, raising concerns about appropriate coding practices. An additional $11 million was billed for puberty blockers given to patients aged 13 to 17 under a diagnosis of unusually early puberty—a condition HHS states is not applicable at those ages.

Financial Incentives and Long-Term Costs

The report suggests that providing these interventions created a long-term revenue stream for hospitals, as minors initiating hormone therapy often require ongoing medical care for years. Outside estimates cited in the report indicate lifetime costs could reach up to $75,000 without surgery, increasing to as much as $170,000 when surgical procedures are included. The Biden Administration is noted within the report as having contributed to the expansion of these interventions through nondiscrimination policies and federal programs.

Federal Policy Shifts and State Restrictions

This week, President Donald Trump moved to end federal Medicaid and Children’s Health Insurance Program (CHIP) funding for gender-affirming procedures for minors, including puberty blockers, cross-sex hormones, and surgeries. These restrictions are set to take effect on October 13th, though states retain the option of continuing such funding independently. The move is part of a broader effort by the Trump administration to restrict policies related to transgender individuals, encompassing medical transition procedures, athletic participation, and military service.

Growing Legal and Funding Challenges

At least 27 US states have already enacted restrictions on gender-transition procedures for minors. Several major hospitals have also ceased offering certain services due to legal challenges, funding pressures, and evolving medical guidance.

The Department of Justice and HHS investigators are currently reviewing the billing practices identified in the report, with potential violations of federal law under investigation.

(With inputs from RT)

Originally published on abcnews.com.np.