00:00I'll recognize, once I give him a little second here to get seated, my friend from Texas, Mr. Gill.
00:09Thank you, Mr. Chairman, and thank you for holding this hearing today.
00:15In foreign countries, we refer to gender reassignment surgeries as child genital mutilation.
00:22In the U.S., we have a much more medicalized and sterile terminology that we use of a gender reassignment surgery.
00:31It's utterly barbaric, and thankfully, we have a president who's serious about ending it.
00:38Dr. Heim, thank you so much for being here.
00:40We really appreciate all the work that you have done and your bravery throughout this process.
00:46I'd like to ask you a few questions.
00:48There's a far-left organization, and it's known as the Campaign for Southern Equality,
00:54and it publicly posts a fact sheet with commonly used insurance codes.
01:03The group claims that, quote,
01:05this information can help provide, guide providers about insurance codes for trans health care
01:11that are commonly accepted and rejected, end quote.
01:15Are you aware of this fact sheet?
01:16I am aware.
01:17You are.
01:18Could you explain maybe a little bit about the sheet and what it's commonly used for?
01:22So this is really important, because when you type in gender-affirming care diagnosis codes on Google,
01:28this is one of the top search results.
01:31What this document does is inform doctors at these clinics how to get insurance companies,
01:36rather private or government, to cover interventions without revealing that it's being used for gender dysphoria, right?
01:47So how do you do a mastectomy but then bill an insurance company and not raise any red flags?
01:55For example, like if it's happening in a red state, right?
01:58Well, you bill it as breast reduction instead of a mastectomy, right?
02:04If you have a girl, right, like a 14-year-old girl who you want to prescribe, you know, testosterone for, quote, unquote, gender-affirming care,
02:12you put a male sex in the medical chart, and then you prescribe testosterone for testosterone deficiency.
02:21The only thing the insurance company sees is male testosterone deficiency.
02:25No red flags are raised.
02:27They don't know that they're getting defrauded.
02:28But what this guide is is essentially a template for how to commit medical fraud.
02:35And we should all remember, you know, this is something that people go to prison for.
02:40This is a major deal.
02:42You know, they have entire departments at hospitals for this.
02:44That's right.
02:45So this is a way of guiding doctors of how to defraud insurance companies.
02:50Is that correct?
02:51How to lie to them.
02:52I mean, that's what it says in that, I mean, in, you know, other language, right?
03:00They try to dress it up and make it sound nice, but that's what they're saying.
03:03And this is something that could and likely is being used to subvert the president's executive order.
03:09Is that right?
03:09Oh, yeah.
03:10I mean, it's my suspicion this is happening all over the country, especially in red states.
03:13And in your time in the medical field, have you seen this tactic being used to defraud insurance companies or to misrepresent surgeries that are being done?
03:24In my personal practice, no.
03:27No, because it's such a big deal.
03:29Right.
03:29Everything you do has to be by the books.
03:32Everything you write on a medical chart has to be true.
03:35It has to support a certain diagnosis.
03:37That diagnosis has to be related to a treatment.
03:41If there's any break in that link, that's a big problem.
03:45People go to prison for that.
03:46Have you ever heard of a health care provider using some of these tactics or using a wrong insurance code?
03:52Yeah, I've heard about it, and those people are in prison.
03:55And you suspect, to be clear, that this is currently a recurring practice.
04:01Yeah, and, you know, there's a few cases in Texas where the attorney general of Texas has, and, of course, this is before litigation.
04:08You know, we have to remember that people are innocent until proven guilty, that he brought three doctors in Texas up for violating SB14, right, for this, a similar scheme, which has been outlined in his suits against them, where they're using false diagnoses and then misrepresented sexes in order to bill insurance companies to conceal, quote-unquote, gender-affirming care in Texas after the passage of SB14.
04:33Yep, thank you, Dr. Heim.
04:36I'd like to yield the remainder of my time to the chair.
04:39I appreciate it, my friend from Texas.
04:41I appreciate the witnesses.
04:42Ms. Sivage, earlier, your credentials as a nurse were challenged, I think, with respect to your ability to make the observations you came here to testify.
04:51Would you like to respond to that?
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