Thoughtful agency rule- and policymaking in healthcare, informed by medical science and stakeholder input, is a good and necessary thing. Agency rule- and policymaking in the absence of such guidance is not. Not only may it be unlawful, but it can easily become a public health hazard. A recent decision from New York’s Appellate Division, Third Department underscores this point well, in addition to highlighting the importance of the judiciary’s role as a check on agency abuses of power in the healthcare space.