The Department of Justice is investigating UPMC Children's Hospital of Pittsburgh over alleged fraudulent billing practices connected to gender-transitioning medical treatment for minors, according to the Pittsburgh Post-Gazette.
The probe is part of a broader Trump administration review of medical facilities nationwide that provided hormone therapy, puberty blockers, and related services for transgender youth.
Federal investigators are examining whether hospitals misrepresented diagnoses or services to insurance companies in order to obtain coverage for treatments that otherwise might not have been reimbursable.
Subpoenas issued to UPMC and other providers seek detailed records of patient care, billing codes, and internal communications about how these procedures were classified, the Post-Gazette reported Thursday.
Further, the DOJ's Oct. 2 filing claims that "allegations and evidence" suggest that UPMC Children's Hospital of Pittsburgh and the Children's Hospital of Philadelphia may have misrepresented children's medical diagnoses to secure insurance coverage for drugs prescribed off-label as part of pediatric gender-transition care, according to the report.
While the filing stops short of making direct accusations against UPMC Children's, it states that federal investigators possess information specific to CHOP indicating potential violations of federal healthcare laws, the report said.
UPMC officials have stated the hospital is cooperating with federal authorities and maintains it has complied with all state and federal laws.
In September, UPMC announced it would halt gender-transition care for patients under 19, citing legal risk and new federal guidance warning that such treatments could expose providers to criminal liability.
Advocates for transgender youth have filed state discrimination complaints, arguing the hospital's decision effectively denies medically necessary care. Civil rights groups contend that the investigation is politically motivated and threatens privacy and access to treatment for vulnerable patients.
The Justice Department's review has not produced formal charges, but if prosecutors determine hospitals knowingly falsified billing information, they could face civil or criminal penalties under federal healthcare fraud statutes.
The case has reignited national debate over the legality, ethics, and funding of transgender medical care for minors.
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