The Justice Department has hauled a Rhode Island hospital into a Texas courtroom fight, asking a federal judge in Fort Worth to order Rhode Island Hospital to hand over medical and administrative records tied to pediatric gender-related care. In an April 30, 2026 petition, DOJ says the hospital largely refused to comply with a HIPAA administrative subpoena served last summer, producing only a single six-page document in response to 15 separate requests. The dispute is now pending in the U.S. District Court for the Northern District of Texas, Fort Worth Division.
DOJ moves to enforce subpoena
According to the U.S. Department of Justice, the subpoena was issued under HIPAA as part of an investigation into the distribution of certain prescription drugs to minors with gender dysphoria and related disorders. The press release says the Civil Division’s Enforcement and Affirmative Litigation Branch and the U.S. Attorney’s Office for the Northern District of Texas jointly filed the petition to enforce the subpoena after what DOJ describes as the hospital’s failure to comply. Assistant Attorney General Brett A. Shumate is quoted in the filing as demanding “full compliance with validly issued subpoenas.”
What the petition requests
The government’s court filing spells out 15 separate requests reaching back to January 1, 2020, grouped into four buckets: personnel and corporate oversight; billing, coding and reimbursement practices; relationships with drug manufacturers, distributors and pharmacies; and patient-level clinical records and drug-safety documentation. As laid out in the petition, prosecutors say they need those materials to evaluate whether drugs were misbranded, promoted for unapproved uses, or billed improperly to federal health-care programs (petition (PDF)). The filing adds that Rhode Island Hospital “has provided only one document totaling six pages” in response to the fifteen requests.
Where this fits in the bigger fight
Legal analysts view the Rhode Island Hospital dispute as one more front in a broader Justice Department push to scrutinize pediatric gender-care prescribing under the Federal Food, Drug, and Cosmetic Act and related laws. Reporting and commentary note that DOJ has issued similar subpoenas to multiple providers and that some federal judges have recently pushed back on those efforts, as detailed in coverage by Bloomberg Law and legal analysis from Faegre Drinker.
Courts in other jurisdictions have already rejected or narrowed related DOJ demands, and the department reached a separate resolution earlier this year with Children’s Hospital Los Angeles after litigating over a similar subpoena. Recent rulings and state-level challenges to the DOJ approach are laid out in coverage by the Los Angeles Times and analysis from firms such as Lowenstein Sandler.
What comes next in the Fort Worth case
In Fort Worth, the government’s April 30 petition asks the court to compel Rhode Island Hospital to produce the requested documents. If the judge enforces the subpoena, the hospital could be ordered to turn over the materials. If enforcement is denied, DOJ may look to other legal options or appeal. The filing cites the statute that authorizes HIPAA administrative subpoenas in federal health-care investigations, 18 U.S.C. § 3486, and lays out DOJ’s position that its demands are both reasonable and relevant to a legitimate investigation.
Legal implications
Prosecutors frame the inquiry as an effort to determine whether certain drugs were misbranded or improperly promoted for unapproved uses, theories that could trigger civil or criminal exposure for drug manufacturers and, in more limited circumstances, support other enforcement actions tied to fraudulent billing. Judges reviewing prior subpoenas, however, have pressed DOJ on whether the investigations are truly focused on fraud or risk chilling lawful medical practice. That tension is likely to shape how the Fort Worth court views the Rhode Island subpoena.
For additional policy context, several state attorneys general and medical-privacy advocates have publicly opposed broad disclosure of sensitive pediatric records in related cases, as outlined by the California Attorney General.
Rhode Island Hospital did not immediately respond to requests for comment on Friday. Whatever the outcome, the Fort Worth court’s decision on whether to enforce the subpoena or trim back the scope of production is poised to become another touchstone in the ongoing fight over how far federal agencies can go in demanding patient-level records in especially sensitive areas of care.
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