Pennsylvania Federal Court Blocks DOJ Subpoena for Transgender Patient Records

Pennsylvania Federal Court Blocks DOJ Subpoena for Transgender Patient Records

The US District Court for the Western District of Pennsylvania has blocked the US Department of Justice (DOJ) from obtaining patient-specific records of gender-affirming care at the University of Pittsburgh Medical Center (UPMC) Children’s Hospital. The administration claimed the subpoenas were necessary to investigate whether hospitals providing gender-affirming care to minors allegedly violated the Food, Drug, and Cosmetic Act through off-label uses of drugs.

The court had previously quashed part of the DOJ’s subpoenas but offered the government an opportunity to supplement the record regarding its request for anonymized data from UPMC Children’s. While the government’s motion was pending, the DOJ appealed to the Third Circuit, prompting the judge to issue a final order denying the government’s request.

In a scathing order, the court criticized the DOJ’s underlying subpoena as exceeding its statutory authority under the Food, Drug, and Cosmetic Act, and usurping states’ rights to regulate the medical profession. The court rejected the DOJ’s assurances regarding data protection, stating that “true and effective anonymization cannot be achieved.” “The DOJ’s actions in this area are unprecedented, to say the least,” the court continued, and “[r]eliance on historical norms, standards and, frankly, decency, cannot be seen as given.” 

The court is the latest amongst several other district courts to quash DOJ investigative subpoenas issued to providers of gender-affirming care. 

The case is In re: 2025 UPMC Subpoena, case number 2:25-mc-01069, in the US District Court for the Western District of Pennsylvania. 

Florida Marketing Company Owner Pleads Guilty for HIV Medication Fraud, Agrees to Forfeit $2 Million

Jonathan Simeon Gholston, the 35-year-old owner of a Jacksonville, Florida, marketing company, has pleaded guilty to receiving kickbacks as part of a $24 million scheme to enroll Medicare and Medicaid beneficiaries to receive HIV prophylactic medications they did not need. 

As part of his plea, Gholston agreed to forfeit approximately $2,273,000 in proceeds.

According to prosecutors, Gholston’s company targeted low-income communities, setting up tents and tables in low-income areas and offering free, government-sponsored cellphones to anyone who agreed to provide personal information, including health insurance information. Then, a pharmacy with which Gholston’s company had an agreement would use that information to generate prescriptions for HIV drugs and pay $200 to Gholston’s company for each referral, with the pharmacy receiving approximately $4,000 per month in reimbursements for each enrolled person. The beneficiaries did not know they were agreeing to receive HIV medications, and the prescriptions were written by a nurse practitioner who never saw or evaluated the patients. As a result, prosecutors said, 20,316 fraudulent claims were submitted to Medicare and Medicaid, resulting in reimbursements of $11,681,479 from Medicare and $12,536,267 from Medicaid. 

Gholston faces up to five years in prison. The sentencing date has not yet been set.

The case is US v. Gholston, case number 3:26-cr-00025, in the US District Court for the Middle District of Florida. 

Read the DOJ’s press release here. 

Physical Therapy Practice Owners Sentenced to Six Years for Health Care Fraud

The US District Court for the Western District of Pennsylvania sentenced the two owners of a now-defunct Erie, Pennsylvania, physical therapy practice to six years in prison for defrauding federal health care programs through an inflated billing scheme. 

The owners, Aaron W. Hertel and Michael R. Brown, had previously pleaded guilty to one count of conspiracy to commit wire and health care fraud through their business, Hertel & Brown Physical & Aquatic Therapy. In addition to their prison terms, the defendants were ordered to pay a $250,000 fine, with a separate hearing scheduled to determine restitution amounts.

According to prosecutors and the 2022 superseding indictment, the practice inflated its bills to government insurance programs in multiple ways, including billing for licensed physical therapists when patients actually saw unlicensed technicians, billing for more therapy time than actually provided, and scheduling multiple patients with the same therapist simultaneously while billing as if each patient received one-on-one treatment. 

Hertel and Brown had previously pleaded guilty to one count of conspiracy to commit wire and health care fraud through their business. In addition to their prison terms, the defendants were ordered to pay a $250,000 fine, with a separate hearing scheduled to determine restitution amounts. The pair have also agreed to forfeit assets, including the practice’s real estate and equipment and a condominium in Sarasota, Florida.

The case is United States v. Hertel & Brown Physical and Aquatic Therapy, et al., case number 1:21-cr-00039, in the US District Court for the Western District of Pennsylvania. 

Read the DOJ’s press release here.

US Government and Florida Billing Company File Joint Motion to Settle Complaint Over Fraud Allegations in Genetic Testing Scheme

The DOJ has reached a settlement in a False Claims Act lawsuit against AIMA Business and Medical Support LLC. AIMA is a medical coding and billing company accused of aiding a Miami-based diagnostic laboratory in fraudulently billing Medicare for more than $15 million in genetic tests. 

According to the June 2025 complaint, AIMA submitted bills to Medicare for genetic and pharmacogenetic testing on behalf of the laboratory from August 2018 to August 2019, despite knowing the tests were neither medically necessary nor ordered by the patients’ treating physicians. The parties filed a joint motion stating they had “amicably settled” the case and requested a 60-day stay while they finalize the terms of the agreement.

The case is USA v. AIMA Business and Medical Support LLC, case number 1:25-cv-22507, in the US District Court for the Southern District of Florida.