Texas Children’s Statement on Medicaid

For over 70 years, our commitment to providing the highest quality care for children and women has been unwavering. This includes following all Medicaid regulations in our billing and collections practices. We have compliance systems in place that are specifically designed to further ensure payment integrity. When we first learned of these allegations last month, we immediately initiated a thorough and comprehensive review of our billing practices. Upon completing our initial investigation into all relevant cases and all relevant Medicaid billing rules and regulations, we found no evidence of fraudulent billing.

In addition, new allegations were brought to our attention last week from the U.S. House Oversight and Government Reform Committee’s Subcommittee on Government Operations and the Federal Workforce. These latest claims pertain to allegedly fraudulent diagnoses given to patients to obtain Medicaid approval for gender dysphoria treatment that would otherwise be denied. We have processes in place for these types of concerns to be raised, and recognize the seriousness of such a claim. An internal investigation is already underway. Thus far, we have not uncovered any evidence of the alleged behavior.

Texas Children’s never condones any criminal act. We welcome additional information that may help our internal investigation. It goes without saying that if we uncover any rogue or unauthorized criminal activity, we will take swift action to correct the issue. To reiterate, our internal investigation to-date has found no basis to substantiate any allegations of Medicaid fraud. All services provided by Texas Children’s were permitted according to Medicaid billing and payment guidelines that were in effect at the time care was provided.

We are proud to be the largest Medicaid provider in Texas and take our responsibilities under the program very seriously. We understand the trust that families place in us when they come to Texas Children’s and we will continue to pursue excellence in all aspects of our care.