A new report by the Senate Finance Committee says four attorneys general in conservative states have abused their authority to investigate transgender patients and their health care, and hospitals must do more to protect them.
Report, titled “How State Attorneys General Are Targeting Transgender Youth and Adults by Weaponizing the Medicaid Program and Their Health Oversight,” examines how attorneys general in Tennessee, Missouri, Indiana and Texas are investigating hospitals for alleged Medicaid fraud or consumer protection violations. laws. The report claims that they opened the investigations “to achieve ideological and political ends” and that “there were significant differences in hospitals’ responses to such requests and their approach to protecting the privacy of one of the most vulnerable patient populations—LGBTQIA+ people.”
The investigations come as hundreds of state bills have attempted to roll back transgender rights in the past few years. In recent years, 24 states have passed restrictions about gender-affirming medical care for trans minors, including puberty blockers, hormone therapy and surgery.
The report singled out Vanderbilt University Medical Center, which turned over medical records of transgender patients to Tennessee Attorney General Jonathan Skrmetti. As part of Skrmetti’s investigation in June alleged medical billing fraud.
“Vanderbilt University Medical Center (VUMC) in Tennessee sits at one extreme: the hospital did not object in any material way to the Tennessee Attorney General’s sweep request, and then provided some material to the Tennessee Attorney General, causing undue terror to young patients and their families. by falsely informing some patients of the required records and then again of the disclosure of medical records that did not occur,” the report said.
“Report” informs that VUMC submitted its correspondence with the Prosecutor General’s Office to the employees of the Finance Committee. Over a seven-month period, from December 2022 to June 2023, VUMC provided Skrmetti’s office with 65,000 pages of documents, including “the medical records of 82 transgender patients, 72 of whom were Medicaid beneficiaries,” the report found in the correspondence.
VUMC notified patients that their records were released on June 19. “After receiving this information, many patients became suicidal and experienced significant emotional distress, including depression and anxiety,” the report said. citing the ongoing class action filed against VUMC by two patients whose medical information was submitted to the Prosecutor General.
Michael Regier, the medical center’s general counsel and secretary, said the hospital disputed the report’s findings and “sent a detailed letter outlining our concerns with the proposed findings prior to release.”
“Under current law, state and federal government agencies are allowed to seek medical records for investigations, and health care providers must comply. In this case, we made every effort to both protect our patients and comply with the law,” Regier said in an emailed statement. “We have never violated any privacy laws, and we absolutely do not agree with any suggestion we make. VUMC remains committed to protecting patient privacy within the law and ensuring that everyone who visits our facilities receives world-class medical care.”
Skrmetti’s investigation into VUMC is ongoing and is “only targeting health care providers, not any patients,” Skrmetti spokeswoman Amy Lannom Wilhite said in an emailed statement.
“Our Civil Medicaid Fraud Unit began an investigation after viewing a video in which a VUMC physician described how he manipulated billing codes to avoid insurance coverage limits. There are no political exceptions to our fraud laws, and we will continue to investigate as the evidence warrants, regardless of a physician’s ideology,” Wilhite wrote.
VUMC declined to comment on Skrmetti’s investigation and the video.
The Finance Committee report found that the two hospitals, unlike VUMC, made various efforts to avoid releasing transgender patient records to state attorneys general. Washington University School of Medicine in St. Louis refused to share records with Missouri Attorney General Andrew Bailey in February 2023 when Bailey requested a civil investigation, citing the state’s consumer protection law. The university cited concerns about the Health Insurance Portability and Accountability Act, which protects privacy and patient information, and filed a petition in state court asking whether Bailey had the authority to investigate.
“As a father of four, this fight is personal for me. “There is no more important court battle than ensuring Missouri remains the safest state in the nation for children,” Bailey said in an emailed statement.
“My team will understand how this clandestine network of clinics exposes children to puberty blockers and irreversible surgeries, often without parental consent,” he said, mischaracterizing how juvenile transition care is provided. State laws require doctors to obtain parental permission to provide any care to minors and are widely used. standards of care does not recommend surgery for minors except in rare cases.
Madeline Sieren, Bailey’s spokeswoman, said her office is awaiting a court ruling on the University of Washington’s request, but judges have ruled in favor of the attorney general in similar cases. Children’s Mercy Hospital in St. Louis, St. Louis Area and Planned Parenthood of Southwest Missouri and Planned Parenthood Great Plains.
The Finance Committee report also found that Seattle Children’s Hospital “took a hard line” against Texas Attorney General Ken Paxton after he subpoenaed the hospital in November over suspicions that it provided gender-affirming medical care to transgender minors living in Texas. in cases where such care of minors is prohibited. Hospital filed a petition He denied the subpoena in Travis County District Court in December. Work continues.
Paxton’s office did not respond to a request for comment.
Along with Tuesday’s report, more than 40 Democratic members of Congress, including Senate Finance Committee Chairman Ron Wyden of Oregon, also sent letters urging member hospitals from five hospitals and health associations to “protect the medical privacy of American patients.” abusive statutory requirements of state attorneys general”.
“AGs in at least four states have abused their statutory authority to require hospitals and other health care facilities to release complete and identifiable medical and billing records of transgender youth and adults,” the lawmakers wrote in President Dr. They write in a letter addressed to Bruce Siegel. and CEO of America’s Essential Hospitals, a hospital association with more than 300 members. “These thinly veiled political attacks come at the expense of vulnerable patients. We are concerned that hospitals are flouting their duty to protect patient privacy and are laxly complying with the AG’s demands.”
Democratic senators sent similar letters to the American Hospital Association, the American Hospital Federation, the Children’s Hospital Association and the National Rural Health Association.
Wyden said in a statement Vanderbilt, in particular, “failed to fulfill its responsibility to protect the privacy of its patients,” and noted that they feared the potentially far-reaching effect of such waivers of privacy by hospitals, particularly in Roe v. After Wade was overturned, it “opened the door to the criminalization of women’s personal reproductive health choices.”
“Several red state attorneys general are abusing their power to terrorize transgender teenagers in their states, violating patient privacy and causing real harm to vulnerable children and adults in the process,” Wyden said. “It’s shameful that law enforcement officials choose to target teenagers trying to live their lives just to score points with far-right activists.”
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