NYU and UPMC Pay $9.45 Million in DOJ Deals, Pushing Hospital Settlement Total Past $24 Million

Since Texas Children's Hospital became the first hospital to settle with the Justice Department in May, six major U.S. hospital systems have now reached deals ending puberty blockers, cross-sex hormones and surgeries for transgender minors. The newest agreements, with NYU Langone Hospitals and the University of Pittsburgh Medical Center, were announced last week and pushed the disclosed dollar total past $24 million, according to a tally by The Advocate.

NYU Langone agreed to pay the federal government $8.5 million. UPMC agreed to pay $950,000, according to the Daily Wire and the Associated Press. Those figures come on top of earlier deals: Mount Sinai Health System committed $2 million toward care for people who want to detransition, according to The Ticker, while Cleveland Clinic, Connecticut Children's Hospital and Texas Children's Hospital reached their own undisclosed or partial arrangements since May.

Deputy Attorney General Todd Blanche said in a statement, quoted by the Daily Wire, that the resolutions "send a clear message: hospitals that target children in these practices and then fraudulently obtain payment for the procedures will be held to account." The Justice Department says its nationwide investigation, which examines potential violations of the Food, Drug, and Cosmetic Act and the False Claims Act, is ongoing.

None of the six hospitals admitted wrongdoing. NYU and UPMC specifically denied the underlying allegations, according to the Daily Wire. The Advocate reported that the DOJ's own Sept. 18 press release did not provide public evidence of the fraudulent billing it alleges, meaning the claims remain allegations rather than proven findings, and no court has made a liability determination.

What the deals actually change

Under the agreements, hospitals stop providing puberty blockers, cross-sex hormones and surgical procedures to patients under 18 or 19, depending on the deal. Several hospitals, including Mount Sinai, also agreed to fund care for patients who want to detransition. The settlements end the federal investigations into past care and remove the threat of hospitals being compelled to turn over patient records through subpoenas, according to ABC News.

A separate legal fight was already underway. Lambda Legal, the New York Civil Liberties Union, the ACLU and class counsel in Coe v. Blanche said in a Sept. 23 joint statement that an injunction they won in July already barred NYU and Mount Sinai from disclosing patient information to the DOJ, and that the order "remains in full effect." Their statement called the NYU deal "beyond shameful," arguing the Trump administration "strong-armed" the hospital into an agreement that "betrays transgender young people in New York."

Eliel Cruz, co-founder of the Gender Liberation Movement, made a related argument to the Associated Press: "It's a really dangerous precedent when the federal government is allowed to politicize any one group of people's care and end it." If the DOJ can use investigative leverage and the threat of losing federal funding to end a category of care without ever proving fraud in court, critics argue that sets a template usable against other medical practices regardless of which party controls the White House. ABC News also noted that major medical groups, including the American Medical Association and the American Academy of Pediatrics, continue to support keeping gender-transition treatment available to minors, putting the settling hospitals at odds with their own professional associations even as they say the deals won't change how their mental health programs treat transgender kids.

On the other side, Dr. Kurt Miceli, chief medical officer of Do No Harm, said in a statement carried by the Daily Signal that "nearly two dozen systematic reviews have found no credible evidence supporting these interventions," citing infertility, cardiovascular disease and surgical complications as known or expected harms. Will Hild of Consumers' Research argued nonprofit hospitals "embrace a radical political agenda over their core mission of patient care" and said they "need to be held responsible for putting politics over patients."

Mount Sinai's own account, cited by The Ticker, complicates the picture further. The hospital said its settlement includes "an express denial of any wrongdoing," and that closing the program was the fastest way to protect patient confidentiality from grand jury subpoenas, not a concession that the care was harmful. That statement conflicts directly with how Consumers' Research and Do No Harm are framing the same settlements as vindication.

The DOJ has not made its fraud evidence public, and no court has ruled on the underlying claims because none of the six cases went to trial. Whether the Coe v. Blanche injunction actually prevented any patient data from changing hands, as Lambda Legal insists, or whether the settlements achieve something functionally similar through hospitals voluntarily shutting the programs down, remains the open legal question as the DOJ says its broader nationwide investigation continues.