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NYU and UPMC agree to end specified pediatric services and pay $9.45 million to resolve federal investigations

NYU and UPMC agreed to specified pediatric service restrictions and payments totaling $9.45 million to resolve investigations; both denied allegations and no liability determination was made.

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What happened

DOJ announced September 18, 2026 agreements with NYU Langone Hospitals and the University of Pittsburgh Medical Center resolving investigations of potential federal violations associated with gender-affirming care for minors. According to the announcement, the institutions will cease providing puberty blockers, cross-sex hormones and surgical procedures to minors. NYU agreed to pay $8.5 million and UPMC $950,000, a combined $9.45 million. These are the institutions' reported resolution commitments; the announcement does not establish that every other provider is subject to the same terms.

The release connects the investigations to potential Food, Drug, and Cosmetic Act, False Claims Act and other federal health care-law violations, including allegedly false diagnosis codes used for reimbursement. DOJ credited both institutions for cooperation, including ongoing cooperation concerning other entities. It expressly states that the resolved claims are allegations only, no liability determination was made and NYU and UPMC denied all allegations. Those distinctions matter when using the event to review billing support or service governance: a settlement is different from an adjudication of the allegations. Counsel should assess the executed terms and applicable state and federal obligations before drawing operational conclusions for a particular organization.

Scope and timing

Authority status
Settled
Applicability
Operationally relevant
Audience
Health systems, Provider networks
Jurisdiction
Federal, New York, Pennsylvania

Why it matters

The resolutions put diagnosis support, reimbursement representations and service-line oversight in the same risk review, while retaining entity-specific and disputed-claim limits.

Case details

agencies
U.S. Department of Justice, HHS Office of Inspector General, Food and Drug Administration Office of Criminal Investigations
entities
NYU Langone Hospitals, University of Pittsburgh Medical Center
action Type
Resolution agreement
event Date
2026-09-18
alleged Conduct
Potential violations involving pediatric services and allegedly false diagnosis codes used to obtain federal program and private-insurer payment. The institutions denied the allegations, and there was no determination of liability.
resolution
NYU agreed to pay $8.5 million, UPMC agreed to pay $950,000, and both agreed to cease the specified services for minors.

Operational lessons

  • Service-line decisions require coordinated legal, coding, pharmacy, and executive oversight.
  • Diagnosis codes used to support payment need contemporaneous clinical support.
  • Cooperation can materially shape a resolution even when allegations are denied.

Sources

Complete edition and supplemental material

This finding in the complete approved report →

Regulatory horizons, CIA trends and implementation trackers remain in the full report.

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