The US District Court for the Northern District of Texas on June 18, 2025 vacated portions of the HIPAA Privacy Rule to Support Reproductive Health Care Privacy (2024 Final Rule) related to reproductive healthcare privacy. The ruling in the case of Purl, M.D. v. US Department of Health and Human Services granted judgment in favor of the plaintiffs. Notably, the opinion only addressed reproductive healthcare privacy-related aspects of the 2024 Final Rule, and the court severed the provision of the 2024 Final Rule requiring updates to the HIPAA notice of privacy practices requirements relating to confidentiality of substance use disorder health records. That requirement remains intact and becomes effective February 16, 2026.
As discussed in our previous blog post, the Department of Health and Human Services (HHS) issued the 2024 Final Rule with the intention of enhancing safeguards surrounding the use and disclosure of protected health information related to reproductive healthcare. Covered entities were required to comply with certain provisions of the 2024 Final Rule by December 23, 2024. Even before its effective date, the 2024 Final Rule faced multiple legal challenges as described in our previous blog post, including the Purl case.
Filed October 21, 2024, Purl was brought on behalf of healthcare providers operating walk-in clinics in Texas. The plaintiffs challenged the 2024 Final Rule’s restrictions on the disclosures of reproductive health information to state welfare agencies and law enforcement when reporting suspected abuse. They argued that the 2024 Final Rule conflicted with Texas law requiring providers to report certain situations, such as minors seeking abortions, contracting sexually transmitted diseases, or receiving prohibited treatments for gender dysphoria, including hormone therapy.
In late 2024, Judge Matthew Kacsmaryk granted a preliminary injunction preventing HHS from enforcing the 2024 Final Rule against the plaintiffs. However, in the recent June 2025 ruling, he expanded that relief to include a nationwide injunction, finding that HHS exceeded its statutory authority to issue the 2024 Final Rule.
As a result of the June 2025 ruling, plan sponsors are no longer required to comply with the additional protections of the 2024 Final Rule relating to reproductive healthcare, including the attestation requirement when responding to requests for protected health information (PHI) that may include such information. Although the court’s decision is consistent with executive orders issued by President Donald Trump directing HHS to withdraw the 2024 Final Rule, HHS has not yet formally withdrawn or amended the 2024 Final Rule. In addition, other legal challenges to the 2024 Final Rule remain pending in federal courts. This decision represents yet another development in a rapidly evolving area of health and welfare compliance, where plan sponsors continue to face shifting and often conflicting compliance obligations.
Our team will continue monitoring other pending cases challenging the 2024 Final Rule, as well as a broader legal challenge by Texas Attorney General Ken Paxton. To date, HHS has not formally rescinded or revised the 2024 Final Rule.