DOJ Signals Increasing Scrutiny of Vertically Integrated Healthcare Companies
On May 19, 2026, Nicole Sarrine, Deputy Assistant Attorney General (DAAG) for Civil Conduct in the U.S. Department of Justice (DOJ) Antitrust Division, signaled increasing suspicion of vertically integrated companies in the healthcare sector in remarks delivered at the Transparency Rising 2026 National Forum.[1] (more…)
DOJ and Texas AG Announce First Settlement in National Investigation of Gender-Affirming Care for Minors
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.
Supreme Court’s First Choice Decision May Expand Federal Court Options to Recipients of State Attorney General CIDs
The U.S. Supreme Court’s recent decision in First Choice Women’s Resource Centers, Inc. v. Davenport may create a new strategic consideration for recipients of state attorney general civil investigative demands (CIDs). In a unanimous opinion, the Court held that a nonprofit could pursue a Section 1983 challenge to a New Jersey Attorney General subpoena in federal court based on alleged First Amendment associational harms arising from compelled donor disclosure.
Although the Court emphasized the narrow nature of its holding, the decision potentially opens the door to federal court challenges where state attorney general CIDs implicate donor anonymity, expressive association, advocacy activities, or other constitutional interests. The ruling also reflects the Court’s continued willingness to recognize Article III standing based on alleged chilling effects tied to First Amendment rights.
Our latest post examines the decision, the arguments raised by a coalition of state attorneys general, and what the ruling may mean for companies, nonprofits, trade associations, and other recipients of state attorney general investigative demands.
New Division Continues Time-Tested Model: DOJ’s National Fraud Enforcement Division Launches West Coast Health Care Fraud Strike Force
In another signal that health care fraud enforcement remains a top priority for DOJ, on April 30, 2026, the newly created National Fraud Enforcement Division (the “Fraud Division”) announced the launch of the West Coast Health Care Fraud Strike Force, a multi-district initiative targeting health care fraud across the District of Arizona, the District of Nevada, and the Northern District of California. This expansion is consistent with the time-tested model of Main Justice-based health care matters that has existed since 2007. Like its predecessor strike forces, the West Coast Strike Force will use dedicated agent and prosecutorial resources in the region to combat schemes identified based on data analytics and traditional law enforcement techniques. This announcement is independently notable because it makes clear that while the Health Care Fraud Unit—rebranded as the Health Care Section of the new Fraud Division—is no longer part of the Criminal Division, it will continue with the same career leadership and approach to enforcement: use of data to expand prosecutorial pipelines, solicitation of whistleblowers, and aggressive pursuit of corporate and individual prosecutions.
DOJ Enforcement Outlook in Health Care Compliance for 2025
Some predicted a drop in False Claims Act (”FCA”) enforcement during the first Trump administration, but setting aside a likely pandemic-related slowdown during 2020–2022, FCA cases — both DOJ-initiated and qui tam — during the early part of the first Trump administration were consistent with the volume in the later part of the Biden administration.
