July 25 could have been a “win” for the Biden administration: It finally would propose new and expanded regulations and protections to implement Section 1557 of the Affordable Care Act, which prohibits sex discrimination in health care settings.^[1]

On the call with reporters to explain the proposed regulations, which have a comment deadline of this fall, were HHS Secretary Xavier Becerra, the head of Medicaid & Medicare Services, and Melanie Fontes Rainer, the acting director of the Office for Civil Rights (OCR)—the pivotal agency that not only enforces HIPAA rules but also nondiscrimination requirements in health care programs.

Melanie Fontes Rainer—now that was a new name. Lisa Pino had been appointed OCR director just 10 months earlier, and she was still listed on the agency’s website as its leader (and still was as of Aug. 8). Taking attention away from the 1557 regulations, reporters wanted to know: Where was Pino, and why was she being replaced after what appears to be the shortest tenure in OCR’s history?