Tennessee Attorney General requests transgender clinic patient records in Medicaid fraud probe

NASHVILLE, Tenn. (WTVF) — NewsChannel 5 has obtained new information in the controversial state investigation into billing practices for the Transgender Care Clinic at Vanderbilt University Medical Center.

According to Vanderbilt, 160 patients who used TennCare for their insurance from 2018 until now had their medical records requested by the Tennessee Attorney General. A VUMC spokesperson said that’s only a small portion of patients in TennCare who utlized their services.

The requested patient records were turned over unredacted, meaning personal information was included in the transfer. VUMC said that’s required under state law.

According to court filings, the Tennessee Attorney General requested significant documentation, including resumes and contracts, for volunteers at the center’s Trans Buddy program. Another request asked for communication to and from two different VUMC doctors that was related to billing practices involving transgender care.

This all stems from Tennessee Attorney General Johnathan Skermetti’s investigation into potential Medicaid fraud. The investigation involves Vanderbilt’s Transgender Care Clinic.

According to the Attorney General’s office, a Vanderbilt doctor “publicly described her manipulation of medical billing codes to evade coverage limitations on gender-related treatment,” Elizabeth Lane Johnson, Press Secretary for Attorney General Skrmetti, said in a statement.

House Democratic Caucus Chairman, Rep. John Ray Clemmons (D-Nashville) said Medicaid billing fraud is a serious allegation that should be investigated.

“I think if the Tennessee Attorney General has sufficient grounds to investigate that, then by all means, he should investigate that,” Clemmons said.

But Clemmons also thinks Skrmetti is requesting documents that extend well beyond the scope of investigating billing fraud.

“We have never had such a politically motivated Tennessee Attorney General that has shown willingness to abuse that power. Our concern here is solely about is he or is he not abusing that broad power to target specific individuals,” Clemmons said.

In response, the Attorney General’s spokesperson said requesting these medical records is standard procedure, and that their office will securely maintain the medical records.

“This investigation is directed solely at VUMC and related providers, not at patients or their families. The records have been and will continue to be held in the strictest confidence, as is our standard practice and required by law. This same process happens in dozens of billing fraud investigations every year,” Johnson wrote in a statement.

But Clemmons is worried that with this going through the courts without being under seal, patient information will be made public.

“It almost indicates he’s trying to create some sort of blacklist of individuals and allow for the specific targeting of a facility, of providers and of patients,” Rep. Clemmons said.

House Majority Leader Rep. William Lamberth (R-Sumner County) fired back at Clemmons.

“These are serious allegations of abuse against vulnerable patients. I commend the Tennessee Attorney General’s office for taking it seriously and I trust their efforts to go where the facts lead. I find it very disappointing that Democrat leaders want to make this a partisan issue and are apparently perfectly fine with insurance fraud,” Rep. Lamberth said in a statement.

This all comes as Tennessee lawmakers passed a bill that goes into effect July 1, banning many forms of pediatric gender affirming care in the state of Tennessee.

As a result of the bill, VUMC announced they would end the practice of gender affirming care for minors.