Tag: health care

Democrat Senate Candidate Roy Cooper’s Pay-to-Play Healthcare Push Made Him Rich

North Carolina Democrat Senate candidate Roy Cooper benefited substantially from healthcare companies while serving eight years as the state’s governor. Records show state-awarded contracts went to companies who made donations to entities connected to Cooper while he also owned stocks in investment funds featuring those same companies.

The state of North Carolina transitioned from a fee-for-service model to managed care for its Medicaid program in legislation passed in 2015. Under the fee-for-service model, the state’s health department reimbursed physicians and healthcare providers based on the number of services they provided. The managed care model gives contracts directly to health insurance companies.

Cooper was elected governor in 2016, meaning his administration would select the winners of the contracts when the transition took effect.

One company, United Healthcare, received one of the coveted contracts from Cooper’s administration in 2019 as he took in $142,184 in contributions.

Cooper prodded the state legislature for years to expand Medicaid in the state, which finally occurred in 2023 and extended coverage to over 600,000 North Carolinians. Medicaid expansion succeeded in growing the enrollment base flowing through that same United Healthcare contract, boosting Cooper’s stock portfolio.

His relationship with healthcare giant Centene links millions in donations directly to his time as governor.

Centene’s North Carolina-based subsidiary also won regional Medicaid contracts from Cooper’s administration in 2019, and the company later acquired WellCare, which held one of the four statewide contracts awarded in that same round.

Cooper chaired the Democratic Governor’s Association (DGA) in 2021-22 when Centene gave $1.45 million to the group — also timed with his continued push to expand Medicaid in North Carolina.

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‘Wolves In White Coats’: 5 Key Takeaways From HHS Report On Alleged Pediatric Gender-Treatment Fraud

A report released Aug. 13 by the Department of Health and Human Services (HHS) has shined a light on alleged fraud by health providers who performed pediatric gender procedures.

The report, titled “Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of ‘Gender Medicine’,” examined the actions and motives of 225 healthcare institutions and found they allegedly put profits and gender ideology ahead of patient needs.

Here are five key takeaways from that study.

HHS Alleges Insurance Coding Fraud

The HHS report laid out an alleged pattern of deception, encouraged by groups promoting gender procedures in children, where hospitals and healthcare providers utilized incorrect insurance codes to ensure they got paid.

Rather than use already-existing, specific codes related to gender identity disorders, HHS alleged they used what the study called “proxy diagnosis codes” that were vague, or outright false.

One common diagnosis was “endocrine disorder—unspecified,” which allowed doctors to bill for cross-sex hormones. HHS data showed that between 2015 and 2025, more than $42 million was billed to insurance companies under the unspecified disorder diagnosis.

A 2023 study by the University of Iowa Hospitals and Clinics found that out of 1,480 patients diagnosed with unspecified endocrine disorder, only 71 actually had such an illness. An analysis by the Manhattan Institute also found a 30 percent rise in such diagnoses between 2020 and 2022, HHS said.

Another common miscoding was for “precocious puberty,” which allowed the doctors to prescribe and bill insurers for puberty blockers. The study found that between 2015 and 2025, insurers were billed more than $11 million under this diagnosis for patients aged 13 to 17.

But that can’t be accurate, the report said, because 13 to 17 is the natural age for puberty.

Advocates Encouraged ‘Alternative Diagnosis Codes’

The World Professional Association of Transgender Health, Planned Parenthood, and other groups encouraged healthcare providers to use “alternative diagnosis codes” not related to gender dysphoria, the HHS report stated.

The Epoch Times reached out to these organizations for comment.

In one instance, a Harvard-affiliated gender clinic called Fenway Health advocated using “more vague” diagnosis codes, but also warned that using inaccurate coding is illegal.

Another organization, the Campaign for Southern Equality, put together a toolkit called “Insurance Coding Alternatives For Trans Healthcare” that outlined workarounds for patients with gender dysphoria.

Most insurers exclude gender procedures unless state law requires coverage, the document states. The toolkit shows which coding is frequently rejected by insurers, and which commonly accepted codes to use instead.

If the insurer denies coverage, the toolkit suggests appealing repeatedly. After the third appeal, the case “goes to an outside agency, and is often accepted.”

For example, a patient can claim orchialgia—persistent pain in the testicles—to justify surgical castration, according to the report.

“How do you do a mastectomy, but then bill an insurance company and not raise any red flags? … You bill it as breast reduction instead of a mastectomy,” said Dr. Eithan Haim, an author of the report.

“This guide is essentially a template for how to commit medical fraud. We should all remember that this is something that people go to prison for. This is a major deal.”

In 2024, Haim was indicted by the DOJ for allegedly exposing private information on patients after he accused a Texas hospital of secretly providing gender surgeries on minors in violation of state law. His case was dismissed with prejudice the next year.

Lifelong ‘Captive Patients’ and Revenue

So-called gender affirming care is lucrative as the “captive patients,” as the report called them, require continual medical maintenance that can last decades—or a lifetime.

“You take a little girl and put her on testosterone, or a little boy and put them on estrogen. Well, they’re going to be on that forever and ever, right?” Assistant HHS Secretary Adm. Brian Christine said in an interview with NTD, The Epoch Times’ sister media outlet.

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B.C. government has given $8.7M to group hosting ‘jockstrap’ dance parties

Have you ever heard of the HIM (Health Initiative for Men) Society?

Founded as a grassroots organization focused on gay men’s health, HIM entered into a formal contract with Vancouver Coastal Health in 2009 to deliver health-promotion services.

Today, it says it provides health-based programs and services for gay, bisexual and queer men and gender-diverse people. Over the past seven years, according to HIM’s CRA filings, the organization has received more than $8.7 million from provincial and federal government sources.

So, what exactly are taxpayers helping fund?

For one, HIM hosts something called the “HIMBO Jock Tea Dance,” where attendees are invited to show up in jockstraps and “lube up” their thighs for the event.

Culture Guard, a political advocacy organization that says it works to protect traditional family values and ways of life, first put HIM on my radar. Culture Guard sent a public accountability letter to Premier David Eby, asking why his government continues to provide substantial public funding to a registered charity involved in events like the “HIMBO Jock Tea Dance.” 

Let me show you some of what Culture Guard highlighted, using screenshots from HIM’s own website.

For example, there is their “QUEERLY DESIGNED & LOCALLY MADE” merchandise. HIM’s website describes it as the “horny lovechild” of HIM. And then there is their “Collab,” inviting adult-content creators to sit down together and build community.

HIM describes some of these activities through the lens of HIV prevention. On its own website, the organization says: “Connectedness is HIV prevention,” and “Dancing together is HIV prevention.” It has continued to receive substantial public funding through provincial health authorities, such as Vancouver Coastal Health, Interior Health, and Fraser Health, as well as from the federal government.

Like Culture Guard’s letter to Premier Eby, I too have reached out to clarify whether your tax dollars have actually gone to preventing disease or to funding sexually charged jockstrap dance parties and adult content communities for the gay and queer men in BC.

I have not yet heard back at this time.

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Second SickKids staff member charged in child sexual exploitation case in less than a month

Another employee at Toronto’s Hospital for Sick Children is facing serious criminal charges related to child sexual exploitation, less than a month after a physician at the same children’s hospital was arrested on similar allegations.

Antonio Alvin Dela Cruz, 55, worked on SickKids’ housekeeping team. Toronto Police say he faces five charges stemming from an online child-luring investigation, including luring a person under 18 by means of telecommunication, making sexually explicit material available to a person under 18, exposing genitalia to a person under 16, and accessing and possessing child sexual abuse and exploitation material.

According to police, the Internet Child Exploitation Unit began investigating in October 2024. Investigators allege Dela Cruz communicated with a 15-year-old through social media and phone chat applications, made inappropriate comments and sent explicit images.

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Following Damning Report Vice President Vance Announces Criminal Refererals of Healthcare Providers Subjecting Children to ‘Horrific, Experimental Treatments in Service of Radical Gender Ideologies’

The U.S. Department of Health and Human Services (HHS) released a report, Wolves in White Coats: How Doctors and Hospitals Pushed and Profited from the Fraud of “Gender Medicine,” a commissioned report examining insurance coding practices, perverse financial incentives, and the provision of sex-rejecting procedures for minors.

According to the report, more than 225 hospitals and health systems have established pediatric gender programs nationwide. Additionally, approximately $50 million in insurance claims were filed for puberty blockers billed using an endocrine disorder diagnostic code, and nearly $11 million in claims for patients ages 13-17 were billed using a diagnosis code for “precocious puberty.”

According to Mayo Clinic, “Precocious puberty is when a child’s body starts developing secondary sexual characteristics (the physical changes of puberty) earlier than usual—typically before age 8 in girls or before age 9 in boys.”

Today, Vice President JD Vance, as Chairman of the White House Task Force to Eliminate Fraud, and Secretary Kennedy referred hospitals and clinics identified by the report to the Department of Justice and the HHS Office of Inspector General, respectively, for possible violations of federal law.

In a press release announcing the report, HHS Secretary Robert F. Kennedy, Jr, said, “Doctors and hospitals must put children’s health ahead of ideology and financial gain.”

“This report identifies troubling billing practices that demand scrutiny. HHS will follow the evidence, protect taxpayers, and hold accountable anyone who broke the law or violated the trust of patients and families. Under President Trump’s leadership, we are restoring transparency and integrity to American medicine.”

CMS Administrator Dr. Mehmet Oz added, “CMS has a duty to ensure taxpayer dollars are spent lawfully and honestly. When billing practices obscure what care was actually provided, especially when children are involved, we have an obligation to follow the facts. We will protect the integrity of our programs, demand accountability, and make sure the American people are not footing the bill for sex rejecting procedures that inflict potentially irreversible harm on young patients.”

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Trump Admin Ends Federal Medicaid Funding for ‘Sex-Rejecting’ Drugs and Surgeries for Children

The Trump administration announced Tuesday that it is banning Medicaid and Children’s Health Insurance Program (CHIP) funding from being used for “sex-rejecting” drugs and surgeries for children.

“Today, we are ending federal taxpayer funding for sex-rejecting procedures on children,” U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. said in a statement.

“These interventions carry serious risks and can cause irreversible harm. The federal government will no longer use Medicaid and CHIP dollars to fund procedures that fail to meet the evidentiary standard our children deserve,” he continued.

The Centers for Medicare and Medicaid Services (CMS) said it is implementing the final rule “consistent with its commitment to protect children from experimental and life-altering sex-rejecting procedures that carry serious long-term health risks and lack sufficiently reliable evidence of clinical benefit.” The agency said the funding ban applies to puberty blockers, cross-sex hormones, and surgical interventions for minors, which “can result in irreversible damage, including infertility, impaired sexual function, diminished bone density, altered brain development, and other lasting physiological effects.” 

“Children deserve our protection, not experimental interventions that pose serious risks and convey no proven benefits,” CMS Administrator Dr. Mehmet Oz said in a statement. “By cutting off federal funds for these sex-rejecting procedures, we’re following the science, saving taxpayer dollars, and, most importantly, protecting children from potentially irreversible harm so they can truly flourish.”

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‘Excrement’ on the Beaches: Ceuta Health System on Brink of ‘Collapse’ Following Migrant Invasion

A budding health crisis appears to be fomenting in the Spanish autonomous territory of Ceuta amid reports of groups of illegal migrants creating unsanitary conditions on the city’s beaches and even schools, which are claimed to be littered with garbage and “excrement”.

In the wake of upwards of 72,000 illegals flooding across the border from Morocco last month, health officials are warning that the Spanish exclave with a population of just 87,000 is not equipped to handle the needs of the thousands of migrants who have remained in the area.

Speaking on the Espejo Público news programme on Spanish broadcaster Antena 3, University Hospital of Ceuta doctor Guadalupe Sánchez warned that the city is facing a “humanitarian catastrophe” with the mass influx of migrants overwhelming the healthcare system and the local government’s ability to house them.

With many of the remaining migrants being forced to live in makeshift accommodations on Ceuta’s beaches, Sánchez said that people are afraid to go down to the beaches, saying: “They are occupied, they are full of huts, people are eating there, throwing food, it’s full of clothes, of excrement, of cigarettes.”

“With all the diseases I’m seeing, because my WhatsApp is full of photos of people from Ceuta who say ‘look at what came out on my child’, impetigo, mange, contagious diseases, this is a sanitary catastrophe.”

“The beach is contaminated; it is contaminated because, this has to be said, they are peeing, they are doing their necessities, they are bathing,” the doctor added.

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Report: Democrats Spent $20M on Healthcare Program for Just 173 Migrants

Democrats in Washington state rushed through the approval for a new $20 million program for healthcare for migrants, but a look at the program’s expenditures finds that the fund only covered 173 migrants instead of the initial 300 of 1,200 the program was eventually meant to help.

Democrats and their NGO migrant advocates pushed the healthcare bill to cover 1,200 noncitizen residents in the Evergreen State. And the Democrat-controlled legislature was quick to vote to fund the program.

But according to the Service Employees International Union (SEIU) 775, which pushed hard to get the program approved, the money is only enough to cover 173 noncitizens, a fact that the union’s secretary-treasurer, Adam Glickman, called “disappointing and frustrating,” the Washington State Standard reported.

Lawmakers are now saying that to actually cover the entire 1,200 group of noncitizens, the program will have to be refunded to the tune of tens of millions more dollars.

The initial $20 million investment was meant to cover 300 noncitizens in the 2026-27 fiscal year. But the money quickly ran out before even reaching 200. To fund the entire initial 300 migrant target, at least $100 million or more will be required. And to fund the full 1,200 migrants it will cost $100 million every year, Democrat Rep. Nicole Macri said.

Washington Democrats launched the program due to the cuts in Medicaid instituted by the Trump administration, which ended coverage for noncitizens. State Democrats say that 14,000 noncitizens will be cut off from Medicaid by October.

The failure of the state program to fund healthcare for the migrants losing federal funding has sent activists back to the drawing board and is spurring them to push state Democrats for millions more in state tax dollars to fund medical care for migrants.

SEIU 775 leaders are ramping up the pressure on state Democrats to throw tens of millions more at the program, their excuse being that unionized home healthcare workers could lose jobs after federal funding is cut.

But union official Glickman thinks it may be an uphill battle thanks to wild budget overreach and deficits already plaguing the state. “Getting the entire thing seems pretty challenging, given this budget situation. We are pushing for them to do as much as they can,” he said.

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The Vanishing Art of Presence

Medicine is always changing. In my career, I have seen intensive care units go from simple rooms with oxygen, monitors, and clinical intuition to places where artificial intelligence can predict problems before we notice them, bedside ultrasound helps us avoid guessing, and robotic systems help surgeons work with great precision. Telemedicine now lets specialists care for patients who are far away. These advances have saved lives, made care more accessible, improved efficiency, and helped doctors reach patients who might not have seen a specialist otherwise.

Many studies show how valuable telemedicine is, especially in underserved areas and critical care settings where specialists are scarce (1). I welcome these innovations and use many of them daily. I am convinced that artificial intelligence (AI) will become one of the most important tools doctors have ever had. Recent reviews also suggest that AI will help doctors make decisions, not replace them (2). Still, no matter how advanced our tools get, they should help us do our jobs better, not change what our jobs are about.

A recent lawsuit about the death of a very sick young man has sparked a lot of talk in the medical community (3). Reports say that one question is whether the doctor in charge ever actually examined the patient in person. The courts will figure out what really happened, so I won’t guess or assign blame. What worries me is not the lawsuit itself, but the bigger question it raises. Are we starting to think that because technology lets us care for patients from a distance, being there in person is no longer necessary?

When I started practicing medicine, this question would have seemed impossible. We took blood pressure by hand, read chest X-rays on lighted boxes, and depended on physical exams because we had no other choice. We were always close to our patients. We shook hands, sat with families during hard times, and listened not just to heartbeats and breaths, but also to the pauses, the worry in a spouse’s voice, the fear behind hopeful words, and the small signs that told us more than any lab test. Sometimes I think those moments taught us as much as any textbook.

Today, we have abilities my mentors never dreamed of. We can look at scans from across the world in seconds. A neurologist can check on a stroke patient from far away. An intensive care doctor can watch over several ICUs at once from a central location. Algorithms constantly review patient data and spot patterns we might miss. These advances are real progress, and many people are alive today because doctors were willing to try new technology. Ignoring these innovations would not just be unwise—it would be wrong.

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Little-Known Bureaucratic Procedure Pushed Medical Insurance To Be More Pro-Trans

Cultural shifts sometimes happen in ways you can’t help but notice, like the sudden growth of transgender themes on television. But there are also a bunch of quiet maneuvers you don’t see, producing change through obscure bureaucratic procedures.

To begin your introduction to one of those little-noticed avenues of change, take a moment to read the Independent Medical Review (IMR) obtained by California health care regulators in 2025 on behalf of a biological male (in the record, a “transgender female”) who wanted his health insurance company to buy him a prosthetic “vagina”.

The transgender patient had a history of depression, “with possible psychotic features,” and was taking anti-psychotic medication when his insurer denied coverage for a surgically created artificial vagina. (Surgical neo-vaginas are created by penile inversion, or less frequently by cutting out a piece of the patient’s bowels and sewing it into a surgical hole between his legs.)

Appealing that decision, the potentially psychotic patient asked the California Department of Managed Health Care (DMHC), which regulates health insurance plans, to conduct a review in which an independent medical expert would decide if his surgery was medically necessary.

A finding on an IMR is binding. Insurers must cover procedures an “independent expert” finds “medically necessary.” As the state’s IMR request form says: “Health plans must follow the IMR decision and promptly provide the service.”

In this case, a psychiatrist reviewed the patient’s surgical request, with no review by a surgeon. The psychiatrist overturned the insurer’s refusal to pay. A male on anti-psychotic medications got a surgically implanted fake vagina, in a procedure covered by insurance, because a psychiatrist found the surgery to be medically necessary.

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