Administrative Subpoenas Seeking Documents Related to Gender Affirming Care Must Show a Proper Purpose and Relate to a Federal Health Care Offense

Over the last year and a half, hospitals nationwide have been targets for administrative subpoenas seeking information related to the provision of gender affirming care (“GAC”) on minors. This slew of administrative subpoenas issued by the U.S. Department of Justice (the “DOJ”) to hospitals has prompted concern related to both the DOJ’s authority to seek such information as well as a provider’s obligation to comply with federal privacy law. A recent Massachusetts district court decision offers guidance to hospitals and providers who may be faced with a similar subpoena on this or other federal investigation initiatives.

The impetus for the administrative subpoenas that were issued beginning in June 2025 go back to several executive orders focused on the prioritization of enforcement actions against providers performing GAC on minors. Following those executive orders, Attorney General Pamela Bondi issued a memorandum (“Bondi Memo”) directing the Civil Division of the DOJ to undertake appropriate investigations regarding GAC. Pursuant to the Bondi Memo, the Civil Division issued a subsequent memorandum (“Civil Division Memo”) noting that it will “prioritize investigations of doctors, hospitals, pharmaceutical companies, and other appropriate entities consistent with these directives.”

The Civil Division Memo was issued on June 11, 2025. That same day, the DOJ served several administrative subpoenas to hospitals across the country, seeking the production of documents related to each hospital’s staff and its provision of GAC on minors. The administrative subpoenas identified 15 document requests that included: (i) any and all information for the hospital’s personnel, documents, and communications regarding the use of billing codes in connection with GAC for minor patients; (ii) communications with pharmaceutical manufacturers in connection with GAC for minor patients; and (iii) documents and medical records of patients, including their social security numbers and home addresses.

On July 8, 2025, the Boston Children’s Hospital, one of the subpoena targets, moved to quash the DOJ’s administrative subpoena. On September 9, 2025, the District Court of Massachusetts granted that motion and quashed the subpoena. The Court noted that an agency that issued an administrative subpoena must prove that:

• The subpoena is issued for a congressionally authorized purpose;
• The information sought is relevant to the authorized purpose;
• The information sought is adequately described; and
• Proper procedures were employed in issuing the subpoena.

Analyzing each of these requirements, the Court found that, although the DOJ is authorized by statute to issue a subpoena if it relates to a federal healthcare offense, the DOJ failed to show a proper purpose. It was not enough for the DOJ to refer to the Bondi Memo as sufficient authority. The Court also recognized that although the DOJ referenced the various executive orders and memoranda that detail the current administration’s goal of ending GAC for minors, the DOJ provided no support “that the information sought by the subpoena is limited to these potential healthcare offenses, as opposed to the … goal of ending GAC for minors.” The Court concluded that the government cannot use administrative subpoenas to broadly inquire about a hospital’s provision of GAC generally; it must be limited to healthcare fraud that is authorized by the statute. Ultimately, the Court concluded that the subpoena contained “overbroad requests for documents and information seemingly unrelated to investigating fraud or unlawful off-label promotion.”

Upon receipt of any subpoena—administrative or judicial—that is outside of the normal requests regularly received, a hospital should promptly seek guidance from its health care legal team to assess its validity, scope, and compliance obligations. Moreover, hospitals should maintain a clear record of how the subpoena was reviewed, what documents were identified, and how decisions were made regarding production or objection. Such documentation may be critical in any subsequent legal proceeding. By taking a proactive and informed approach, hospitals can protect their legal interests, safeguard patient confidentiality, and ensure compliance with applicable laws when responding to subpoenas in a politically and legally complex environment.