The legacy media are carefully avoiding this point, but Texas Children’s Hospital (TCH) has just formally admitted to deceitful and potentially fraudulent behavior during the years they spent providing illegal sex-rejecting medical procedures to children. They lied, repeatedly and aggressively, and they’ve been forced to say so.
As The Federalist previously reported, the announcement in May of a settlement between TCH and both the Department of Justice and the Texas Attorney General’s Office was premature. The agreement in May was an agreement in principle on a set of topics that still required negotiation to produce a signed and executed agreement.
That final settlement agreement has now been signed and released, and it’s damning. As a summary filed in federal court reads, “This case concerns fraud on Medicaid. Texas Children’s Hospital and doctors there provided ‘gender-affirming care’ to patients in violation of Texas’s Medicaid program requirements and by attributing treatments to false diagnoses. Those patients were primarily part of Texas Children’s Health Plan, a Medicaid managed care organization, which knowingly or recklessly failed to stop the fraud. These entities and the doctors who committed the fraud violated the False Claims Act and the Texas Medicaid Fraud Prevention Act.”
You can read the complaint and settlement agreements in the case here (scroll down for the list of documents), in an announcement from the Burke Law Group, which represented former TCH nurse Vanessa Sivadge in a whistleblower lawsuit.
Coverage in publications like the Houston Chronicle say only that TCH has agreed to stop providing transgender procedures, and then they fudge the rest with sentences like this: “The probe into the hospital was then expanded in 2024 after a nurse alleged the hospital was obscuring its care for transgender youth by intentionally miscoding patients’ treatments in order to receive Medicaid payments.”
But this is no longer an allegation. By signing the settlement agreement, TCH has agreed to a description that says it obscured transgender procedures with dishonest billing codes:
To pay for transgender procedures for children, TCH and its providers pretended that those children had illnesses that they didn’t have. Then they billed insurance for the treatment of the fake illnesses.
Under the terms of the settlement, TCH agrees to the “Permanent Cessation of Sex-Rejecting Procedures,” and to “irrevocably terminate” the appointments and clinical privileges of a list of doctors who participated in those procedures. The hospital has also agreed to implement a long series of administrative and compliance procedures that will assure no recurrence of sex-rejecting procedures, including the creation of “a compliance and ethics program.”
Agreeing to open a destransition clinic to provide medical treatment to children mutilated by sex-rejecting procedures, TCH has committed to opening that clinic within 90 days.
Finally, the hospital will pay $8,576,000 to the State of Texas, and an additional $1,715,200 to Sivadge, the former TCH nurse, while also making a separate payment in an undisclosed amount for her attorneys’ fees and legal costs. Those costs will likely mean very little to a hospital that reports annual revenue of a little over $3.8 billion, with total assets near $8.5 billion.
“This settlement sends an unmistakable message: if you put radical ideology over children’s health, my office will go after you,” Texas Attorney General Ken Paxton said in a statement released by his office.
