A medical watchdog group is calling on the Department of Health and Human Services to investigate Planned Parenthood’s billing practices, alleging that some affiliates may have used improper diagnosis codes to secure insurance reimbursement for cross-sex hormone treatments, according to reporting by The Daily Wire.
Do No Harm sent a letter to HHS Inspector General Thomas Bell outlining what it describes as “potential coding discrepancies” found in an analysis of claims data. The group’s investigation, which The Daily Wire says it reviewed exclusively, examined billing records tied to Planned Parenthood affiliates between 2015 and 2025.
Allegations of strategic miscoding
In the letter, Do No Harm claims that affiliates may have “deliberately miscoding services to mask their true purpose and to facilitate the improper reimbursement of cross-sex hormone treatments.” The group says it found evidence that some Planned Parenthood affiliates have encouraged the practice of “strategically miscoding medical encounters” when billing for transgender medical interventions.
The watchdog points to public statements from regional Planned Parenthood affiliates that, it argues, openly advertise facilitating insurance reimbursement by using inaccurate diagnosis codes. The letter cites representations that affiliates use such codes to “meet the needs of most insurance companies,” which Do No Harm characterizes as a “well-known strategy for evading insurance scrutiny via intentional miscoding.”
The investigation was prompted by concerns that Planned Parenthood—described as one of the nation’s largest providers of so-called “gender-affirming” hormones—could be “miscoding claims at scale.”
“The transgender industry has become a lucrative business with expensive treatments and long-term patients,” the group writes in the letter. It adds that providers are aware insurers, including government programs like Medicare, Medicaid, and TRICARE, reimburse only for treatments deemed “medically necessary,” and that many of the procedures in question do not fit that requirement.
Data analysis and patient numbers
Do No Harm says it worked with a professional data broker to collect claims-related information on hormone prescriptions written by Planned Parenthood affiliates from 2015 to 2025. The dataset included diagnosis codes from office visits and hormone prescriptions where the prescriber was associated with Planned Parenthood affiliates.
Specifically, the group examined diagnosis codes for Planned Parenthood office visits that occurred within 30 days prior to a hormone prescription claim. From this, Do No Harm isolated a subset of approximately 800 patients ages 22 and younger from across the country. According to the letter, those patients received between 1,100 and 1,200 prescriptions seemingly related to gender dysphoria while the associated office visits potentially lacked the correct diagnosis codes.
“An investigation by HHS is warranted because Do No Harm’s own investigation, while valuable, has limitations that are inherent in a private actor’s attempt to root out another private actor’s wrongdoing without any of the government’s tools,” the letter states. The group is asking the government to further investigate what it calls a “potential miscoding scheme.”
Background and context
The request follows a recent HHS report that scrutinized billing practices in the transgender medical industry. That report, according to The Daily Wire, found evidence suggesting providers across the U.S. have deliberately used fraudulent billing codes to obtain insurance coverage for procedures including puberty blockers, cross-sex hormones, and mastectomy surgery. It also claimed that organizations such as the World Professional Association of Transgender Health have encouraged such practices.
Do No Harm argues that many sex-rejecting procedures are “at best” experimental and pose a “risk of significant harms” with only speculative benefits. Because insurers reimburse only for medically necessary care, the group contends that some providers deliberately use incorrect diagnosis codes in patient records and on claims to secure payment.
Planned Parenthood did not respond to The Daily Wire’s request for comment.
Source: www.dailywire.com — https://www.dailywire.com/news/exclusive-planned-parenthood-may-be-committing-fraud-to-hide-transgender-procedures-watchdog-says