On May 15, 2026, the U.S. Department of Justice and the Texas Attorney General announced the first publicly disclosed settlement arising from the federal government’s nationwide investigation into gender-affirming care for minors. The resolution with Texas Children’s Hospital reflects a coordinated federal-state enforcement approach grounded in False Claims Act (“FCA”) and Federal Food, Drug, and Cosmetic Act (“FDCA”) theories, alongside significant non-monetary remedies extending beyond traditional healthcare fraud settlements. In addition to a substantial monetary payment, the agreements impose operational, clinical, and governance-related obligations that may signal how enforcement authorities intend to pursue similar matters going forward.

This blog post examines the settlement terms, the broader federal policy and enforcement framework underlying the investigation, and the implications for healthcare providers and life sciences companies navigating areas of aligned federal and state enforcement focus. Click to read more about the resolution and what it may signal for future DOJ and state attorney general enforcement activity.