Claims of fraudulent billing to Medicaid programs for children's gender transition care are currently being investigated by the House Committee on Oversight and Accountability.
The House Committee on Oversight and Accountability is investigating whistleblower claims related to fraudulent billing to Medicaid programs for pediatric gender transition care, including at Texas Children's Hospital in Houston (TCH).
In letters sent to the Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health and Human Services (HHS), members of the committee expressed concern that medical providers at TCH are falsifying diagnosis codes for patients seeking gender transition care not covered under Medicaid.
"We understand a TCH provider seeking to ensure Medicaid coverage of gender transition care appears to have fraudulently diagnosed a biologically female patient with testosterone deficiency and hypogonadism in order to obtain Medicaid approval for testosterone treatment that would otherwise be denied under Texas Medicaid regulations if prescribed for the purpose of gender transition," the letters, signed by Subcommittee on Government Operations and the Federal Workforce Chairman Pete Sessions, R-Texas, and Subcommittee on Health Care and Financial Services Chairwoman Lisa McClain, R-Mich., allege.
Members of the committee also expressed alarm about its perception that the Biden administration is prioritizing action against individuals who made the allegations.
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Dr. Eithan Haim, a Texas surgeon whose residency included rotations at TCH during the timeline in question, is facing four federal felony counts related to alleged violations of the Health Insurance Portability and Accountability Act (HIPAA) after he released redacted documents appearing to expose the hospital's pediatric transgender care program continued after the public had been told such practices had ceased.
The U.S. Attorney’s Office for the Southern District of Texas claims Dr. Haim obtained patient information from Texas Children’s Hospital’s electronic system without authorization.
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"He allegedly obtained this information under false pretenses and with intent to cause malicious harm to TCH," according to federal prosecutors.
Jury selection in Dr. Haim’s trial is set for August 20th.
"If they can come after me as a whistleblower, they're going to come after you," Dr. Haim told Fox News. "So we're going to have to take this to court, and we're going to have to win."
Sessions and McClain allege Dr. Haim’s treatment could intimidate future whistleblowers, writing in the letters to HHS and CMS, "potential whistleblowers seeking to disclose Medicaid fraud and other unlawful behavior have seemingly been put on notice: the federal government will target individuals looking to expose illegal actions at hospitals while turning a blind eye to Medicaid fraud and other wrongful hospital conduct they seek to expose."
The committee is now requesting documents, communication, and a staff-level briefing to learn of any ongoing audits or investigations into fraudulent Medicaid billing related to gender transition care.
The Centers for Medicare & Medicaid Services tells Fox News, "CMS received the letter and will respond to the Members of Congress."
The HHS Office of Inspector General also confirmed the inquiry from lawmakers, telling Fox News, "we received the letter and are currently reviewing it."
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Texas Children’s Hospital has not responded to Fox News’ request for comment.
