Dartmouth Hitchcock faces scrutiny over gender surgery billing claims

During a recent Senate Health and Human Services meeting in New Hampshire, a significant discussion emerged regarding the billing practices of Dartmouth Hitchcock Medical Center related to gender-related surgeries. A representative from the organization Do No Harm presented findings from a comprehensive analysis of insurance claims data, revealing that Dartmouth Hitchcock had billed for 76 patients undergoing gender-related surgeries, totaling over $70,000 in charges.

The analysis, which spanned from 2017 to 2023, utilized a nationwide insurance dataset to cross-reference billing codes specifically associated with gender-related procedures. The findings indicated that the majority of these surgeries were covered by various insurance programs, including Medicaid, Medicare, and private insurers, under provisions established by the Affordable Care Act.

A key point of discussion was the differentiation between medically necessary surgeries and those deemed cosmetic. The representative explained that insurance companies typically require a mental health evaluation and a supporting letter from a mental health provider before approving gender-related surgeries. This process is intended to ensure that the procedures align with diagnoses such as gender dysphoria, which is classified under specific billing codes.

Concerns were also raised about potential fraud within these practices, highlighting the need for vigilance in the verification of claims. The meeting underscored the importance of transparency and accountability in healthcare billing, particularly as it relates to sensitive issues surrounding gender identity and medical treatment.

As the state continues to navigate these complex healthcare discussions, the implications of these findings may influence future policies and regulations regarding insurance coverage for gender-related healthcare services in New Hampshire.