Two hospital systems settle US probe over transgender care billing for $9.5 million

NYU Langone Health system and the University of Pittsburgh Medical Center agree to pay nearly $9.5 million combined to settle a Department of Justice probe into pediatric gender-affirming care billing. Under the agreements, NYU Langone pays $8.5 million and UPMC pays $950,000, and both systems must cease providing puberty blockers, hormones, and surgeries to minors. The settlements, which involve no admission of wrongdoing, follow similar federal agreements with other major hospitals.

Hospital settlement payments

• ▪NYU Langone Health system and the University of Pittsburgh Medical Center agreed to pay nearly $9.5 million combined to settle a U.S. Department of Justice probe into pediatric gender-affirming care billing
• ▪Both NYU Langone Health system and the University of Pittsburgh Medical Center denied any wrongdoing or liability in their respective settlements with the U.S. Department of Justice over pediatric gender-affirming care billing

Pediatric gender care cessation

• ▪NYU Langone Health system had already discontinued NYU Langone Health system's program for treating transgender youth in February 2026, citing the regulatory environment under the Trump administration's crackdown on gender-affirming care for minors
• ▪NYU Langone Health system and the University of Pittsburgh Medical Center committed to cease providing gender-affirming medical treatments, including puberty blockers, hormone treatments, and surgical procedures, to patients under age 18
• ▪NYU Langone Health system and the University of Pittsburgh Medical Center will continue their pediatric mental health programs and gender-affirming care for patients aged 18 and older

Billing fraud investigation

• ▪The Trump administration's investigations by the Justice Department and the Department of Health and Human Services into hospitals' gender-affirming care billing allege that healthcare providers routinely submit claims under false disorder diagnoses to obtain reimbursements from private and government-sponsored health plans
• ▪The settlement agreements between NYU Langone Health system and the University of Pittsburgh Medical Center and the U.S. Department of Justice safeguard the confidentiality of patients, legal guardians, and providers whose privacy was threatened by grand jury subpoenas issued during the Department of Justice's investigation into pediatric gender-affirming care billing
• ▪NYU Langone Health system and the University of Pittsburgh Medical Center agreed to pay nearly $9.5 million combined to settle a U.S. Department of Justice probe into pediatric gender-affirming care billing

Medical debate over treatment

• ▪Mainstream medical and mental health professionals widely agree that gender-affirming care reduces the risk of depression and suicide among transgender youth
• ▪Opponents of transgender healthcare interventions argue that the long-term effects are not fully understood and that youth are too young to make life-altering choices

Previous hospital settlements

• ▪The Trump administration finalized a rule in August 2026 barring two major federal healthcare programs from funding gender-affirming medical care
• ▪The U.S. Department of Justice previously reached agreements similar to its settlements with NYU Langone Health system and the University of Pittsburgh Medical Center regarding gender-affirming care billing with Mount Sinai Health System, Texas Children's Hospital, the Cleveland Clinic Foundation, and Connecticut Children's Hospital