CHOP, Planned Parenthood named in report on questionable gender care billing practices

Beth Ann Rosica’s writings are a blend of news, opinion, and analysis.  

A new report details how local healthcare providers may exploit insurance rules to secure payment for child sex-change procedures.

Do No Harm, a national organization of healthcare professionals established in 2022, seeks to “highlight and counteract divisive trends in medicine, such as Diversity, Equity and Inclusion and youth-focused gender ideology.”

Founder and chairman Dr. Stanley Goldfarb previously served as the Associate Dean for Curriculum at the Perelman School of Medicine at the University of Pennsylvania and “saw with his own eyes how identity politics was invading medical education.”

Its latest report, published last month, explains the potential for insurance fraud by intentionally using incorrect or inaccurate diagnosis codes. The watchdog group identifies two local institutions — Planned Parenthood of Southeastern Pennsylvania and Children’s Hospital of Philadelphia — that may be guilty of such practices. According to the report, these treatments are expensive and financially profitable.

“The rise of the child transgender industry over the past decade has relied, in no small part, on the financial incentives for physicians and hospitals to perform sex-denying medical  interventions. These procedures offer a potentially lucrative revenue source.”

The group illustrates how healthcare providers are able to disguise “gender affirming care” as other legitimate medical services.

“By misrepresenting the medical procedures they are performing, providers can pass off transgender medicalization as, for example, routine endocrine care unrelated to pediatric medical transition.”

The report identifies that Planned Parenthood of Southeastern Pennsylvania (PPSP) explicitly states this practice on its website. 

“In order to meet the needs of most insurance companies and patients, we typically use the code E34.9 (endocrine disorder, unspecified) and occasionally will use F64.9 (gender identity disorder, unspecified) if necessary,” states an answer to frequently asked questions on PPSP’s website. “We recognize that much of the language around billing for gender affirming care is troublesome; we recognize this is medically necessary care and will work to decrease barriers to getting folks the care they need.”

Do No Harm alleges utilization of these inaccurate diagnoses violates insurance coding policies.

“These examples raise legitimate concern that endocrine-related ICD-10 [International Classification of Diseases] codes are possibly being used on their own to obtain reimbursement for so-called ‘gender-affirming care.’” 

The report further explains the only way to validate fraudulent practices is through reviewing actual patient records.

“The medical record remains the definitive source for verification and thus to differentiate appropriate use from potential misuse.”

In June 2025, the U.S. Department of Justice (DOJ) issued a subpoena to Children’s Hospital of Philadelphia (CHOP) requesting medical records of its gender affirming care patients in order to determine whether the institution was using inaccurate insurance codes, in addition to violating federal orders.

CHOP immediately filed a motion to limit the subpoena in federal court as it objected to producing the documents based on alleged privacy violations. CHOP specifically opposed the release of documents related to patient names, dates of birth, clinical diagnoses, and informed consent for children who were prescribed puberty blockers or hormone therapy.

In October 2025, Governor Josh Shapiro, joined by fourteen blue states, filed an amicus brief with the court, supporting CHOP’s position.

Based on Do No Harm’s report, the only true way to determine if CHOP committed insurance fraud is through the acquisition and subsequent review of those medical records.

Neither Planned Planned of Southeastern Pennsylvania nor CHOP returned a request for comment regarding the report.

Do No Harm Chief Medical Officer Dr. Kurt Miceli emphasized that local Pennsylvania institutions are high on their watch list.

“Some of the most prominent organizations we suspect are skirting coding rules to obtain reimbursement for transgender treatments for minors are in Pennsylvania,” said Miceli in response to a Broad + Liberty request for comment. 

“The Department of Justice has alleged that the Children’s Hospital of Philadelphia coded minors aged 14 to 18 with precocious puberty — effectively an implausible diagnosis for teenagers. On its website, Planned Parenthood of Southeastern Pennsylvania has likewise acknowledged using endocrine‑related diagnosis codes when billing for so-called ‘gender-affirming hormone care.’ Our report is an important piece in exposing how bad actors, including those in Pennsylvania, could use alternative diagnosis codes to get paid for these harmful interventions.”

Some Pennsylvania legislators are concerned about the use of taxpayer dollars for gender transition procedures and medications. Republican Senator Chris Gebhard, representing parts of Berks, Lancaster, and Lebanon Counties, introduced Senate Bill 1321, Ending State Funding for Gender Transition of Minors. On May 6, 2026, the bill passed the Senate Banking and Insurance Committee with bipartisan support and a 10 to 4 vote.

“It is NOT lifesaving care, but child abuse in every sense of the word to attempt to physically mutilate and irreversibly change a child’s gender,” said Dush in a press release. “Backed by the full blessing of Gov. Josh Shapiro through yet another federal lawsuit, commonwealth taxpayers are reprehensively being forced to spend millions on sex-rejecting puberty blockers and sex-reassignment procedures for minors that have lifelong physical and psychological impacts. By enacting Senate Bill 1321, Pennsylvania can join the no less than 25 states that have already passed laws protecting minors by eliminating funding for these harmful and unconscionable experimental procedures.” 

As investigations continue, the debate over pediatric gender medicine in Pennsylvania is increasingly shifting from ideology to accountability.The central question remains: were insurance systems used as intended or manipulated to fund controversial treatments for minors? 

Beth Ann Rosica resides in West Chester, has a Ph.D. in Education, and has dedicated her career to advocating on behalf of at-risk children and families. She covers education issues for Broad + Liberty. Contact her at barosica@broadandliberty.com.