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Instead, wrote Pozen, the cutoff must be “limited in its effect to the particular program ... in which noncompliance has been so found.”

Carter’s oversight of those agreements took a sharp turn last year when the Alliance law firm, Umhofer, Mitchell and King, accused the city of noncompliance and asked the judge to fine it $6.4 million.

An HHS spokesperson confirmed that, saying that the letter is “only a preliminary document that does not contain any formal findings of noncompliance” and that Cedars-Sinai had cooperated throughout the investigation.

The report cited the passage in 2023 of a bill that gives the state power to set limits on refinery profit margins, with heavy penalties for noncompliance.

Her noncompliance with what is expected is a gnarly insight into our sense of entitlement to her.