Historic False Claims Act settlement delivers unprecedented accountability, operational reforms, and long-term care for harmed patients
HOUSTON, TX — August 5, 2026 — Burke Law Group, PLLC announced today that it secured a historic and unprecedented settlement with Texas Children’s Hospital (“Texas Children’s”) that sets the bar for enforcement actions against hospitals that provide sex-rejecting “gender transition” procedures to minors and adult patients. The settlement resolves alleged violations that had been ongoing since January 1, 2010 of the federal False Claims Act, the Texas Medicaid Fraud Prevention Act, the federal Food, Drug, and Cosmetic Act, and federal fraud and conspiracy laws on behalf of nurse-whistleblower Vanessa Sivadge.
Under the terms of the agreement, Texas Children’s will:
- Pay a combined total of $10,000,000 in penalties and restitution;
- Build and operate a free Detransition Clinic that will deliver multidisciplinary detransition-related medical care to patients up to and including the age of 21 who underwent sex-rejecting “gender-transition” procedures;
- Issue a Public Statement acknowledging that: (i) the Texas Children’s Providers performed sex-rejecting Procedures on both minor and adult patients; (ii) prior media statements related to these practices are removed and superseded; and (iii) the Texas Children’s Providers have permanently and irrevocably ceased such procedures;
- (a) Permanently and irrevocably terminate all existing privileges, clinical privileges, and staff appointments of three specifically identified current physicians within 90 days; and (b) permanently bar two former physicians from holding any credentials or privileges at any current or future TCH-affiliated facility;
- Implement sweeping operational reforms including training healthcare professionals on applicable federal and state law governing the prohibition of sex-rejecting “gender transition” treatments or procedures, including training employees on internal reporting mechanisms and the whistleblower (qui tam) provisions of the THFPA, including that employees who report violations may be entitled to a portion of any recovery;
- Recommend to the medical staff the adoption of an amendment to the medical staff bylaws specifying that a violation of the TCH Affiliated Entities’ policy prohibiting sex-rejecting Procedures (not limited to minors) is a trigger for “Automatic Relinquishment of Privileges”; and
- Commit to a permanent prohibition on sex-rejecting, “gender-transition” services at any of its facilities, absent a change in the law requiring TCH Affiliated Entities to provide such procedures.
The case, United States ex rel. Doe v. Texas Children’s Hospital, et al., Civil Action No. 4:24-cv-02018, alleged that Texas Children’s Hospital, and the other Texas Children’s entities named in the complaint knowingly submitted false claims to Texas Medicaid, Healthy Texas Women, and Texas CHIP by prescribing puberty blockers, cross-sex hormones, and other sex-rejecting treatments to patients, and billing those services to federal and state healthcare programs using false diagnosis codes.
Under the settlement, three specifically identified current physicians will have all existing privileges, clinical privileges, and staff appointments permanently and irrevocably terminated within 90 days of the Effective Date, and two identified former physicians shall be permanently ineligible to apply for, receive, hold, or exercise any credentials or privileges at any current or future facility owned, operated, managed, under the control of, or affiliated with TCH.
This settlement is the first of its kind in the nation. It goes beyond financial penalties, mandating that Texas Children’s must implement sweeping operational reforms.
Most significantly for the individuals harmed by these practices, the settlement requires Texas Children’s to build and operate a free Detransition Clinic that will deliver multidisciplinary detransition-related care to patients up to and including age 21 who underwent sex-rejecting “gender-transition” procedures—with detransition-related obstetric and gynecological care available to older patients.
The clinic will provide free multidisciplinary services, including Endocrinology, Surgery, Primary Care, Fertility Counseling, Psychiatry, Psychotherapy, Social Work/Case Management, and Speech Pathology. Texas Children’s must provide the clinic’s services at no cost to patients for a period of five (5) years, and donations designated for the clinic will be used to fund free detransition services beyond that initial five-year term.
“We are proud to have fought on behalf of our brave client, Vanessa Sivadge,” said Marcella Burke, Chairman of Burke Law Group. “Through her courage and cooperation with the government, Vanessa helped secure reforms that will begin to address the devastating harm alleged in this case. This outcome reflects the importance of individuals willing to come forward and the government’s commitment to investigating serious allegations and pursuing accountability where appropriate.”
Ms. Sivadge, a nurse at Texas Children’s Specialty Care Cy-Fair clinic, first observed that transgender patients continued to be treated in the Endocrine and Gynecology departments despite the hospital’s 2022 public statement that it had discontinued gender-affirming care for minors.
The settlement resolves a multi-year investigation conducted in coordination with the Office of the Texas Attorney General and the United States Department of Justice. It stands as one of the most comprehensive healthcare fraud resolutions involving a major children’s hospital, combining a significant financial recovery, permanent professional consequences for certain current and former physicians, and lasting structural reforms at the institution. The settlement provides a roadmap for similar enforcement actions across the country.
Access the Disclosure Settlement
Access the Settlement Agreement with the State of Texas
Access the Settlement Agreement with the US Department of Justice
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About Burke Law Group
Burke Law Group is a Houston-based boutique delivering elite legal counsel for high-stakes matters. The firm advises companies across the United States on complex environmental, regulatory, and enforcement matters, high-stakes commercial litigation, and corporate transactions, pairing the sophistication of an Am Law platform with the focus, agility, and responsiveness of a boutique. Burke Law Group was recognized as a leading firm in the 2026 Chambers USA Guide, ranked in Texas for Environment, and Chairman and Managing Partner Marcella Burke is individually ranked for Environment in Texas.