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Enforcement ActionLow RiskMultistate

Oregon AG Coalition Sues HHS Over Gender-Affirming Care Declaration

U.S. Department of Health and Human Services (HHS)December 24, 2025Oregon Attorney General

Summary

Health and civil rights enforcement action. Oregon Attorney General Dan Rayfield led a coalition of 19 states and the District of Columbia in filing a lawsuit against the U.S. Department of Health and Human Services (HHS). The suit challenges a December 18, 2025 HHS 'declaration' that claims certain gender-affirming care is 'unsafe and ineffective' and threatens to exclude providers from Medicare/Medicaid for offering such care. The attorneys general argue HHS violated federal administrative law by implementing a major policy change without required notice-and-comment rulemaking, creating fear for patients and providers and threatening state Medicaid programs.

Remedy

The coalition is asking the U.S. District Court for the District of Oregon to declare the HHS declaration unlawful and issue an injunction blocking its enforcement.

Injunction

Contract Impact

In-house legal teams should review all agreements where the entity is a healthcare provider, vendor, or contractor receiving Medicare/Medicaid funding or serving transgender patients. Focus on clauses governing compliance with federal healthcare regulations, termination rights, force majeure, change-in-law provisions, and definitions of covered medical services. Specific clauses to scrutinize include: (1) compliance certifications referencing federal program requirements; (2) termination clauses triggered by exclusion from federal programs; (3) service description clauses that define reimbursable or permitted care; and (4) indemnification or regulatory risk allocation provisions. Potential changes may involve adding language to address abrupt federal policy shifts, clarifying that service definitions follow prevailing medical standards rather than agency declarations, and negotiating cure periods or renegotiation triggers if federal funding or participation status is threatened.

Contract Search Terms

Medicare/Medicaid participation clausenotice-and-comment rulemaking requirementprovider exclusion provisionfederal funding compliancehealthcare service definitionsmaterial adverse change clausetermination for non-complianceregulatory change clausestate Medicaid program impactspatient care decision-making

Violation Types

Entity Details

Entity

U.S. Department of Health and Human Services (HHS)

Also known as: HHS

Industry

Healthcare

Multistate Coalition

Official Sources

Source Evidence

Entity Name
"U.S. Department of Health and Human Services"
Violation Description
"HHS is attempting to use the declaration to circumvent basic legal requirements for policy changes. Federal law requires agencies to provide the public with notice and an opportunity to comment before making significant changes to health care policy."
Co Enforcers
"Joining Attorney General Rayfield in this lawsuit are the attorneys general of California, Colorado, Connecticut, Delaware, the District of Columbia, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New Mexico, New York, Rhode Island, Vermont, Washington, Wisconsin, and the governor of Pennsylvania."

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No privacy enforcement target identified

The provided press release is a media release from the Oregon Department of Justice announcing a multistate press conference of attorneys general from Oregon, California, Washington, Nevada, and New York advocating for increased state resources to address antitrust enforcement gaps following reduced federal oversight. No privacy-related enforcement actions, violations, penalties, or remedies are described in the document.