Federal prosecutors are seeking to revive subpoenas against medical providers as watchdog groups allege insurers and Medicaid programs were billed using diagnostic codes unrelated to gender dysphoria.
By yourNEWS Media Newsroom
Federal investigators are intensifying efforts to examine whether providers of pediatric “gender-affirming care” improperly used medical billing codes to obtain insurance reimbursement for cross-sex hormones, puberty blockers, and related procedures, according to a report from Just the News.
The controversy centers on allegations that healthcare organizations and advocacy groups advised providers and patients to use diagnostic codes unrelated to gender dysphoria in order to bypass insurance denials and Medicaid restrictions tied to pediatric gender-transition treatments.
Medical advocacy organization Do No Harm alleged in a recent report that several prominent organizations — including World Professional Association for Transgender Health, Planned Parenthood, Campaign for Southern Equality, and QueerDoc — publicly promoted the use of alternative ICD-10 billing codes not specifically designated for gender identity disorders.
According to the report, providers allegedly used endocrine-related diagnosis codes rather than the F64 classification associated with gender dysphoria.
Do No Harm argued that such practices may violate insurance billing standards, Medicaid rules, and state laws restricting pediatric gender-transition procedures or funding.
“By framing these practices under conventional endocrinology or other non-F64 medical diagnoses, providers, at a minimum, circumvent official coding guidelines and ethical billing standards,” the report stated.
The United States Department of Justice is currently pursuing legal efforts to continue investigating healthcare providers over alleged insurance billing fraud and possible falsification of medical records.
Federal prosecutors recently asked the 4th U.S. Circuit Court of Appeals to reverse a lower court ruling that blocked a subpoena issued in July 2025 to Children’s National Hospital.
The hospital had paused pharmaceutical gender-transition treatments for minors following President Donald Trump’s executive order restricting such treatments and later permanently ended them after receiving the subpoena.
The DOJ argued that U.S. District Judge Julie Rubin improperly dismissed the subpoena request by focusing on perceived political motivations rather than investigative standards.
Rubin, appointed by former President Joe Biden, had previously faced Senate questioning involving abortion and gender identity issues during her confirmation process, according to Senate Judiciary Committee records.
Federal prosecutors are also attempting to revive a subpoena targeting QueerDoc, which describes itself as a “Trans Online Doctor’s Office.” A lower court previously quashed the subpoena after a ruling by U.S. District Judge Jamal Whitehead.
The 9th Circuit Court of Appeals heard oral arguments in March and has not yet ruled
The Department of Justice filed a brief in the Fourth Circuit defending our ongoing investigations of consumer protection laws in healthcare services.
DOJ is committed to enforcing compliance with federal law, both in the transgender space and beyond.https://t.co/g18yfO6nCW pic.twitter.com/rMMJv7ihbV
— Brett Shumate (@AAGShumate) April 30, 2026
In a January appellate brief, DOJ attorneys argued the lower court improperly applied a heightened legal standard and blocked the government from pursuing evidence.
Do No Harm Chief Medical Officer Kurt Miceli said financial incentives tied to pediatric gender-transition procedures contributed to the growth of what he described as the “child transgender industry.”
The report alleged that providers frequently used diagnostic code E34.9 — an unspecified endocrine disorder classification — to obtain insurance coverage for treatments related to gender transition.
According to the report, Planned Parenthood of Southeastern Pennsylvania stated it “typically” uses E34.9 for insurance purposes and only occasionally uses the F64 gender dysphoria code.
Similarly, QueerDoc advised patients that E34.9 “can sometimes be used for labs, prescriptions, and visits” and suggested discussing concerns about F64 codes with providers.
The report also cited WPATH training materials connected to its Standards of Care guidelines and a since-removed Campaign for Southern Equality webpage listing insurance billing codes frequently accepted in place of gender dysphoria classifications.
Do No Harm further argued that complex insurance coding systems make it difficult to identify alleged misrepresentation without cross-referencing medical claims, pharmacy records, and diagnostic histories.
The report identified various “red flags,” including testosterone prescriptions issued to adolescent females shortly after office visits lacking gender dysphoria codes and mastectomy procedure codes paired with unrelated endocrine diagnoses.
Miceli also pointed to rising diagnoses of precocious puberty and endocrine disorders among older children as possible indicators of concealed gender-transition treatments.
The report echoed concerns previously raised by whistleblower surgeon Eithan Haim, who was prosecuted by the Biden administration after exposing pediatric gender-transition procedures at Texas Children’s Hospital.
Haim later alleged the Biden DOJ provided inaccurate information to a grand jury regarding whether the hospital had actually ended such procedures after state restrictions took effect. According to Just the News, the Trump administration later dropped the case.
Haim also cited a study published in the Journal of the Endocrine Society involving a physician from Children’s National Hospital that allegedly identified gender-transition patients using the E34.9 billing code.
In separate posts on X, Haim argued evidence supporting DOJ investigations was “plastered all over the internet.”
DOJ's investigation into fraudulent billing codes at Children's National Hospital's gender clinic got shut down because Judge thought they lacked legitimate investigative purpose.
Yet a doctor at Children's National Hospital is lead author on a 2024 study that flagged gender… https://t.co/DjWjkmhRvc pic.twitter.com/nyD4DGgBmj
— Eithan Haim MD (@EithanDHaimMD) May 2, 2026
He later referenced another study published in Transgender Health involving researchers from Boston Children’s Hospital, which identified patients using both F64 and E34.9 diagnostic codes.
In another social media post, Haim argued the study demonstrated why federal investigators were examining billing practices tied to pediatric gender-transition procedures.
Here is another example of gender doctors using the fraudulent diagnosis code, endocrine disorder (E34.9), to flag gender patients at major academic institutions – the same institutions that happen to be under DOJ investigation for using fraudulent diagnosis codes.
This time,… https://t.co/4vsDD3RrhA pic.twitter.com/tqpE5MU17v
— Eithan Haim MD (@EithanDHaimMD) May 2, 2026
The DOJ investigations and ongoing appellate battles could have broader implications for insurance billing practices, Medicaid compliance standards, and future federal oversight of pediatric gender-transition treatments nationwide.
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