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May 05, 2023
Health Law Weekly

Two Hospitals Subject of Federal Probe over Alleged Denial of Emergency Abortion Care

  • May 05, 2023

The Centers for Medicare & Medicaid Services (CMS) is investigating two hospitals the agency says violated the Emergency Medical Treatment and Labor Act (EMTALA) by failing to provide medically necessary stabilizing care to a pregnant woman experiencing premature labor because of hospital polices prohibiting treatment that could be considered an abortion.

The Department of Health and Human Services (HHS) announced May 1 the first-of-its-kind investigation while also releasing a letter HHS Secretary Xavier Becerra sent to hospitals and provider associations across the country to underscore their obligations under EMTALA.

According to Becerra’s letter, the pregnant woman visited two different hospitals after she experienced a preterm premature rupture of membranes at nearly 18 weeks. She was told the pregnancy was not viable. “Although her doctors advised her that her condition could rapidly deteriorate, they also advised that they could not provide her with the care that would prevent infection, hemorrhage, and potentially death because, they said, the hospital policies prohibited treatment that could be considered an abortion. This was a violation of the EMTALA protections that were designed to protect patients like her,” the letter said.

“Fortunately, this patient survived. But she never should have gone through the terrifying ordeal she experienced in the first place. We want her, and every patient out there like her, to know that we will do everything we can to protect their lives and health, and to investigate and enforce the law to the fullest extent of our legal authority, in accordance with orders from the courts,” Becerra added.

CMS will ensure that the hospitals come into compliance with federal law, the letter said.

While the agency did not name the two hospitals, the National Women’s Law Center, which filed a complaint in November 2022 on behalf of the patient, Mylissa Farmer, identified them as Freeman Hospital West in Joplin, MO and the University of Kansas Health System in Kansas City, KS.

According to published reports, a University of Kansas Health System in a statement said the hospital followed its policy and federal and state law, while meeting the standard of care in this case.

After the U.S. Supreme Court overturned Roe v. Wade last year, HHS issued guidance advising providers that EMTALA requires them to render life-or health-saving emergency services, including abortions. The guidance also noted that EMTALA preempts state laws prohibiting abortion that do not include an exception for pregnant people experiencing emergency medical conditions.

A federal district court in Texas preliminarily enjoined certain applications of the guidance, finding it went “well beyond” the text of the EMTALA statute. Texas v. Becerra, No. 5:22-CV-185-H (N.D. Tex. Aug. 23, 2022). The government has appealed that ruling to the Fifth Circuit.

 

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