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Essays · The Hillman Letter

Operator notes from inside regulated medicine.

Essays that walk through FDA regulatory strategy, frontier therapeutics, family office capital, and healthcare compliance. Thirty years of operating experience, written to read in twenty minutes each. Seven essays published. New essays weekly.

The Hillman Letter

The Hillman Letter · Latest · 2026-11-02

Zero Was True. The Claim Was Still False.

Six SNG dialysis centers pay about $2 million after reporting zero revenue to HRSA without disclosing a pre-arranged sale or closure. A true number in a misleading context still supports a False Claims Act theory.

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The Hillman Letter · 2026-10-26

1.25-1.6x Beats Treble: The Six-Month FCA Self-Disclosure Window

DOJ and HHS just put a price tag on coming forward: a 1.25 to 1.6x repayment for disclosing previously unknown civil False Claims Act issues. The clock runs to April 22, 2027.

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The Hillman Letter · 2026-10-19

The Spreadsheet Knew

Two September and October settlements show how a stalled internal review turns into a False Claims Act case. The 60-day overpayment clock is the reason.

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The Hillman Letter · 2026-09-14

The Same Surgical Procedure Loophole Is Closed. Here Is What the Cell Surgical Network Injunction Means for Everyone Building a Cell or Exosome Product.

Eight years, one reversal, and a nine-page order that ends the argument.

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The Hillman Letter · 2026-07-06

Why family offices beat venture capital on early biotech. And where venture still wins.

On where family offices outperform venture capital on early biotech, and where venture still wins.

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The Hillman Letter · 2026-06-08

The hard road. Building a biotech of real value without operating in the gray market.

Issue No. 3 of The Hillman Letter, on building a biotech of real value without operating in the gray market.

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Full archive on thehillmanletter.substack.com.

The Hillman Letter · 2026-06-03

351(a) or 361. The pathway question that determines whether your biologic ever sees a BLA.

The fastest way to lose two years and four million dollars in early biotech is to pick the wrong pathway.

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Essay · 2026-06-11 · 1380 words

The Specific Pattern That Killed Five Biotech Programs I Personally Watched

The pattern was the same across five programs. In case you are running one of the next ones.

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Essay · 2026-06-10 · 1410 words

Why Dallas Is Quietly Becoming the Right Place to Build FDA-Regulated Biotech

The Dallas-Fort Worth biotech ecosystem has been compounding for three decades.

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Essay · 2026-06-09 · 1320 words

The 351 vs 361 Decision That Kills Most Exosome Programs

Why most exosome programs pick the wrong FDA pathway, and what the BLA route actually demands.

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Exosome and mesenchymal stem cell-derived extracellular vesicle products are not approved by the FDA for any indication. References here describe investment focus and published scientific literature. They do not describe an available treatment.
Essay · 2026-06-08 · 1280 words

Why Family Office Capital Fits FDA-Regulated Biotech Better Than Venture Money

A ten-year venture fund has to return capital on a schedule. The FDA does not care about your schedule.

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Essay · 2026-06-07 · 1380 words

The Six Documentation Patterns That Show Up Before Federal Healthcare Enforcement

Every enforcement action I have served on involved a pattern visible eighteen to thirty-six months before.

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Essay · 2026-06-12 · 1480 words

What Thirty Years of Operating in FDA-Regulated Healthcare Actually Taught Me

Five lessons I would tell my younger self if I could.

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Medium · 2026-07-29

The Silent Killer of Biotech Startups: Ignoring the Full Legal Landscape

Argues that many biotech founders underestimate healthcare regulation and wrongly assume basic HIPAA or Anti-Kickback Statute awareness is good enough.

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Andrew Jonathan Hillman

Dallas senior paralegal and healthcare compliance expert witness. Not an attorney.

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