Health Law Daily Wrap Up, HIPAA—N.D. Tex.: Hospital seeks stay of subpoena enforcement pending appeal, (May 7, 2026)

By Patricia K. Ruiz, J.D.

The motion argues due process violations, improper venue, and unlawful scope after Texas court order compelling compliance.

Rhode Island Hospital has asked a federal court in Texas to stay its April 30 order enforcing a Department of Justice (DOJ) administrative subpoena, arguing the order was issued without notice or an opportunity to respond and is likely to be reversed on appeal. The hospital contends that the court’s enforcement decision is procedurally flawed, rests on an improper venue, and compels compliance with an unlawful and overbroad subpoena. It further asserts that immediate compliance would cause irreparable harm, including disclosure of sensitive patient information and unrecoverable costs, while a temporary stay would not substantially harm the government’s investigation (In the Matter of Administrative Subpoena 25-1431-032, Emergency Motion for Stay Pending Appeal, No. 4:26-MC-0006-O (N.D. Tex. May 6, 2026)).

Motion for stay. Rhode Island Hospital filed its emergency motion for a stay pending appeal on May 6 in the Northern District of Texas, seeking to pause enforcement of a subpoena issued under the Health Insurance Portability and Accountability Act (HIPAA), 18 U.S.C. § 3486. The motion follows the court’s April 30 order requiring the hospital to produce all responsive records within 14 days and warning that failure to comply could result in sanctions, including contempt (see Federal court enforces DOJ subpoena to Rhode Island Hospital amid emergency bid to quash, May 5, 2026)).

Enforcement action. The underlying enforcement action stems from a Department of Justice investigation into potential federal health care offenses related to the distribution and labeling of certain prescription drugs. As previously reported, the subpoena seeks records concerning the hospital’s treatment of minors diagnosed with gender dysphoria, including documents relating to clinical practices, billing, and patient-specific information. In its stay motion, the hospital argues it is likely to succeed on the merits of its appeal because the court enforced the subpoena without affording it an opportunity to respond. According to the filing, the government petitioned for enforcement and obtained an order the same day, without prior notice to the hospital or adversarial briefing. The hospital maintains that procedural due process requires notice and an opportunity to be heard before enforcement of an administrative subpoena.

Venue. The motion also challenges the propriety of venue in the Northern District of Texas. It asserts that the government failed to establish any meaningful connection between the investigation and that district, noting that the subpoena was served in Rhode Island and directed production to Washington, D.C., where the DOJ office handling the matter is located. The hospital contends that the record contains no evidence that the investigation is being carried out in Texas.

Authority. In addition, the hospital argues that the subpoena itself is unlawful and exceeds the government’s statutory authority. It disputes the DOJ’s theory that off-label prescribing practices can form the basis for criminal liability under the Federal Food, Drug, and Cosmetic Act, asserting that the statute does not regulate the practice of medicine. The motion further contends that the subpoena seeks information that is not relevant to a valid investigation and is overly broad, particularly in its requests for detailed patient records and personally identifiable information.

Irreparable harm. The hospital also claims that it will suffer irreparable harm absent a stay. It argues that compliance before appellate review would moot its appeal and result in unrecoverable costs associated with collecting and reviewing large volumes of records. The motion emphasizes the sensitivity of the requested materials, stating that disclosure would involve highly personal medical and psychosocial information about minor patients and could damage patient relationships and confidentiality expectations.

Balance of equities. Finally, the hospital contends that the balance of equities and public interest favor a stay. It notes that the government waited approximately ten months after issuing the subpoena before seeking enforcement and did not request emergency relief in its petition. According to the motion, a temporary pause would not prejudice the investigation, while immediate compliance would impose significant burdens and risks on the hospital and its patients.

The case is No. 4:26-mc-00006-O.

Attorneys: Patrick Raymond Runkle, U.S. Department of Justice, for the U.S. Mindy M. Sauter, Eric G. Olshan and Kathryn M. Barber (McGuireWoods LLP) for Rhode Island Hospital.

Companies: Rhode Island Hospital

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