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PaperclipPerfector  1yr ago (text post)   25431 thread views

Culture War Roundup for the week of June 17, 2024

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Some Kind of Brouhaha over Trans Kids in Texas

I'm not actually sure what the one sentence summary is here, so bear with me. https://thetexan.news/issues/social-issues-life-family/paxton-investigates-texas-childrens-hospital-following-second-child-gender-modification-whistleblower/article_d61a2ece-2e6b-11ef-aeaa-cf9abce1d2a4.html

Following reporting from Christopher Rufo, a senior fellow at the Manhattan Institute, of another gender modification whistleblower at Texas Children’s Hospital (TCH), the Texas Office of the Attorney General (OAG) has launched an investigation into the issue.

According to Rufo, he received information from a second whistleblower that “doctors at Texas Children’s Hospital were willing to falsify medical records and break the law to keep practicing ‘gender-affirming care.’”

So two whistleblowers told Chris Rufo that a children's hospital in Texas was doing gender transitions in violation of the law, and he got Paxton to open an investigation. Ok, page five story. Their names are Ethan Haim and Vanessa Sivadge.

According to Sivadge, TCH was “unlawfully billing the state Medicaid program” for the purposes of child gender modification.

Again, kind of boring, but public funds were supposedly being illegally redirected to do illegal things(remember, gender modification is considered child abuse in Texas).

Here's where it gets interesting:

Following Sivadge talking with Rufo, the Federal Bureau of Investigation (FBI) sent agents to her home to “intimidate and threaten her,” in Rufo’s words.

Rufo also previously reported on the first TCH whistleblower, Eithan Haim, who alleged that TCH has continued to provide “gender-affirming care” to minor children.

Since then, Haim has been visited by agents of the U.S. Department of Justice (DOJ) and has been indicted on four felony counts of violating the Health Insurance Portability and Accountability Act, or HIPAA.

So the federal DOJ stands accused of, basically, witness intimidation to enable medicaid fraud. Meanwhile, the Texas government is investigating the hospital for medicaid fraud.

Now, fraudulent medical billing isn't the most interesting story in the world. But the accusations of FBI witness intimidation are https://www.usatoday.com/story/opinion/columnist/2024/06/18/whistleblower-surgeon-trans-kids-gender-affirming-care-texas/74075234007/

Haim recorded evidence of the hospital's ongoing care and passed it on to Rufo. Haim says he redacted any patient information that would violate HIPAA. On May 16, 2023, City Journal published Rufo's story that included Haim's anonymous account of what he witnessed at the hospital. The Texas Legislature then officially banned transgender medical interventions on minors.

Our first whistleblower claims that his releases didn't violate HIPAA; no doubt he didn't air personally identifiable information in the media. But three felonies a day and all; there might well be a crime involved.

Our second whistleblower is more interesting https://nypost.com/2024/06/19/us-news/texas-nurse-alleges-fbi-threatened-her-for-blowing-whistle-on-transgender-care-of-kids/

Vanessa Sivadge, who is a nurse at Texas Children’s Hospital, said the alleged feds “promised they would make life difficult” for her and that she was “not safe at work” after she started speaking out about the facility’s gender affirming care practices.

That sounds... pretty bad.

Texas Attorney General Ken Paxton is investigating her allegations, a spokesperson for his office told The Post.

This could get interesting, if Texas is actually(which this may be bluster, taken out of context, whatever) investigating federal agents for witness intimidation in a medicaid fraud case.

Fun, or at least !!fun!! update:

In the original indictment, Dkt. No. 1, the government charged one count of violating HIPAA under false pretenses. The allegations in the indictment were built around the idea that Dr. Haim had no reason whatsoever to have access to TCH’s electronic medical records (EMR) system after finishing a surgical rotation at TCH in January 2021 because he had no patients there. The specific allegations included that after Dr. Haim completed his rotation at TCH in January 2021, he “did not return to TCH for any additional pediatric rotations or medical care”; in April 2023, Dr. Haim sought re-activation of his TCH login to access “pediatric patients not under his care” but emailed TCH “claiming urgency for adult care services...”; Dr. Haim “did not treat or access any adult care patients during this time period at TCH”; and Dr. Haim claimed “under the false pretenses that he needed to urgently attend to adult care services”...

At the September 26 th hearing on Dr. Haim’s renewed motion for a continuance, counsel for Dr. Haim further revealed that the government should have known about the procedures Dr. Haim performed past his last full rotation at TCH in January 2021 because 1) the government in discovery had provided an audit trail from Dr. Haim’s access to TCH’s EMR system showing that he made entries for TCH patients past the rotation ending date and 2) TCH had told the government as part of a Health and Human Services Office of Civil Rights (HHS OCR) investigation that TCH considered Dr. Haim to have appropriately had access to its EMR system through the relevant times in 2023 because he was continuing to cover patients at TCH even while rotating at other hospitals.

The government has now obtained a superseding indictment. The primary changes include deleting all of the specific allegations noted above that were contradicted by the records TCH discovered and the other evidence in the government’s possession. The deletion of those supporting allegations leaves the sole allegation regarding false pretenses unsupported: “HAIM contacted TCH numerous times under the false pretense that he needed access to the electronic records system for the treatment of patients under his care.” Nevertheless, the government added false pretenses to all of the charges including counts 2–4.

Ed Whelan claims that (Haim's lawyers claim that) Texas Children's Hospital made this disclosure to the government nine months before the indictment, though I will caveat that he is a partisan in general and on this particular topic.

More subtly, the initial indictment's claim :

Instead, HAIM caused malicious harm to TCH, pediatric patients at TCH and its physicians by contacting a media contact, PERSON1.

has since been revised to :

Instead, HAIM, with the intent to use the individually identifiable health information to cause malicious harm to TCH and its physicians, obtained the individually identifiable health information and disclosed portions of the health information to a media contact, PERSON1.

On the other side of things, CBS reports:

Lau is an associate professor in the pediatrics department at UT Southwestern Medical Center in Dallas, according to the UT Southwestern website. The lawsuit said she has hospital privileges at two area Children's Health hospitals. The lawsuit accuses her of "falsifying medical records, prescriptions, and billing records to represent that her testosterone prescriptions are for something other than transitioning a child's biological sex or affirming a child's belief that their gender identity is inconsistent with their biological sex." Paxton is asking the court for an injunction against Lau and for her to be fined as much as $10,000 per violation.

The stated defense is hard to take seriously -- "doctors should not have to fear being targeted by the government when using their best medical judgment" is absolutely not a rule that cuts where the ACLU disagrees with the practice -- and a steelman of Paxton's position focused specifically on the fraud bit would be pretty strong. In turn, though, these also aren't exactly the central examples of a surgical and/or sterilizing interventions, instead being purely hormonal or implanted-hormonal processes for patients between the age of 14 and 17, and it's near-certain that Paxton doesn't really distinguish these cases from his central ones.

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