HHS Report Tallies $120 Million in Pediatric Gender Care Billing Since 2019
A Department of Health and Human Services report released in 2025 quantifies the federal billing footprint of pediatric gender-related medical procedures and raises questions about coding...
The U.S. Department of Health and Human Services released a report finding that hospitals and clinics billed approximately $120 million in gender-related medical treatments for patients under 18 years of age between 2019 and the report's data cutoff, according to the HHS document cited by multiple outlets in August 2026. The report is a product of the Trump administration's HHS and was produced under the department's policy review authority. The full report is publicly available through HHS.gov and serves as the primary source for the billing total cited here.
The report alleges that some pediatric gender clinics used billing code practices that may constitute insurance fraud, including what the document describes as misclassification of procedures to obtain reimbursement from public and private insurers. The specific codes flagged in the report, and the number of claims reviewed, are detailed in the HHS document. The Congressional Times has not independently verified the underlying claims data; verification would require access to the Centers for Medicare and Medicaid Services claims database and the insurers' own records.
Pediatric gender care has become an active area of federal and state legislative activity. As of August 2026, at least 25 states have enacted laws restricting or banning gender-related medical procedures for minors, according to the National Conference of State Legislatures tracker. At the federal level, Congress has held committee hearings on the topic in both the House Energy and Commerce Committee and the Senate Health, Education, Labor and Pensions Committee, though no single comprehensive federal statute has been enacted into law as of this publication date.
The American Academy of Pediatrics and the World Professional Association for Transgender Health have each published clinical guidelines supporting certain gender-affirming interventions for minors under specific protocols. Both organizations have disputed characterizations of such care as categorically fraudulent. Their formal responses to the HHS report, if any have been issued, are not yet reflected in the congressional record or in HHS's public comment log as of August 13, 2026.
Several questions central to evaluating the report's findings remain unanswered by publicly available records. The HHS document does not specify how many individual providers or institutions are named in the billing irregularity findings, nor does it disclose whether referrals to the Department of Justice or the HHS Office of Inspector General have been made. A request to the HHS OIG's publicly available referral log, and the DOJ's civil division case records, would indicate whether enforcement actions are being pursued. The Congressional Times will update this report if those records become available.