Health Law Advisor

Bill Gates published an essay this week arguing that the AI transition will be one of the most turbulent periods in modern history.  And critically, neither governments nor industry have a plan to manage it. While the essay has far-reaching implications for all industries and humanity generally, three key risk categories emerge for health care and life sciences organizations. It is a useful moment to connect his framing to what is actually showing up in legislative bodies, enforcement actions, and litigation.

On August 12, 2026, U.S. Department of Health and Human Services (“HHS”) Secretary Robert F. Kennedy Jr. sent a letter (“Referral Letter”) to HHS Inspector General T. March Bell, targeting more than 250 health care entities providing gender-affirming care to minors “for investigation into possible violation of federal statutes.”

On July 21, 2026, Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. announced (the “July 21 announcement”) that he would be providing to the Centers for Medicare & Medicaid Services (CMS) the exclusion authority currently within the exclusive domain of the HHS Office of Inspector General (HHS-OIG)—that is, the power to exclude individuals and entities from participation in federally funded health care programs.

When a provider or supplier of services bills the Medicare program and receives payment, but at a later date the program audits the claim and denies it, can the provider or supplier be relieved of any financial liability if it had a good faith belief that the service met all relevant coverage requirements, even when that belief is incorrect? In a recent decision, the U.S. Court of Appeals for the Sixth Circuit ruled that this relief is possible, and that administrative adjudicators must conduct an analysis under the “hold harmless” provision of the Social Security Act (the “Act”).[1]

[1] In Home Health, LLC v. Kennedy, 2026 WL 2147418 (6^th Cir., July 27, 2026); also available at: https://www.opn.ca6.uscourts.gov/opinions.pdf/26a0205p-06.pdf.

On August 13, 2026, Senior U.S. District Judge B. Lynn Winmill of the District of Idaho issued a ruling in Seyb v. Members of the Idaho Board of Medicine, holding that Idaho’s near-total abortion ban is unconstitutional to the extent it prohibits abortions necessary to protect the health—not just the life—of the pregnant patient. Along with that holding, the court entered an injunction barring enforcement of the ban in those circumstances. The ruling is the first federal district court decision since Dobbs v. Jackson Women’s Health Organization to hold that the U.S. Constitution affirmatively protects a right to health-preserving abortion.

On July 31, 2026, the Health Resources and Services Administration (“HRSA”) announced a revised 340B Rebate Model Pilot Program (“2026 Pilot”) to provide a rebate mechanism through which qualifying manufacturers may effectuate the 340B ceiling price for certain drugs sold to covered entities—as opposed to an upfront discount, which has been the longstanding model. The 2026 Pilot, which is limited to the drugs selected for negotiation under Medicare, is open to qualifying manufacturers that submit plans meeting specific criteria.

On August 13, 2026, the Assistant Attorney General for the U.S. Department of Justice (“DOJ”) National Fraud Enforcement Division (the “NFED”), Colin M. McDonald, released a memorandum outlining NFED’s enforcement priorities. The memorandum is the first memo of this kind from NFED.  The establishment of NFED earlier this year represented a watershed moment for federal fraud prosecution, as it established DOJ’s first-ever division dedicated exclusively to combating fraud against taxpayer dollars and taxpayer-funded programs.  With a stated goal of having 500 prosecutors and staff by August 24, NFED seeks to deploy “cutting-edge data analysis” across a “whole-of-government” effort.  The establishment of NFED signals a fundamental shift in federal fraud enforcement, one that seeks to compress investigation timelines and narrow the window for voluntary disclosures.  Breaking down data barriers, eliminating silos, and establishing partnerships with U.S. Attorneys’ Offices, federal agencies, and state and local partners, the NFED’s priorities are a warning call to companies to expect more efficient detection, investigation, and prosecution than in the past.  The creation of the NFED signals a desire on the part of the Trump administration (“Administration”) to meaningfully escalate federal fraud enforcement sophistication and resources.

On August 7, 2026, Epstein Becker Green attorneys Thomas J. Jaworski and Caitlin Carlton joined podiatrists from across the country at the American Podiatric Medical Association’s (APMA) 2026 Annual Scientific Meeting for a discussion on a subject that has become increasingly difficult for providers to ignore: federal health care fraud enforcement.

Less than a month remains for physicians, health systems, technology companies, and other stakeholders to comment on several questions buried deep in a Request for Information (“RFI”) within the Centers for Medicare & Medicaid Services’ (“CMS”) Calendar Year 2027 Physician Fee Schedule Proposed Rule. Among them is a deceptively simple question: “What are the payment implications of including technology in primary care?”

The federal government is pursuing restrictions on gender-affirming care through a coordinated, multifaceted enforcement strategy.

For health care providers, understanding both the tools being deployed and the methods providers are using to respond is essential to compliance planning.

Jennifer Nelson Carney, Member of the Firm, examines the federal enforcement mechanisms and discusses how health care organizations are responding to coordinated federal challenges.