The Centers for Medicare and Medicaid Services are investigating two hospitals that “failed to provide essential stabilizing care to a person experiencing a medical emergency in violation of the Emergency Medical Services and Labor Act (EMTALA)”, according to letter from US Secretary of Health and Human Services Xavier Becerra.
Under the EMTALA, healthcare professionals are required to “offer treatment, including abortion, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition,” Becerra said Monday in a letter to the national associations of hospitals and healthcare providers.
V National Women’s Law Centerwhose statement says it filed the original EMTALA complaint on behalf of Milissa Farmer, identified the hospitals as Freeman Hospital West of Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas.
The patient was 18 weeks pregnant when her membranes ruptured prematurely, writes Becerra, but was told her pregnancy was not viable.
“While her doctors told her that her condition could deteriorate rapidly, they also told her that they were unable to provide her with care that would prevent infection, bleeding, and possibly death because, they said, hospital policy forbade treatment that could be considered an abortion,” wrote Becerra.
Becerra added in a statement on Monday: “Fortunately, this patient survived. But she never had to go through the horrific ordeals she experienced in the first place. We want her and every patient 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 powers.”
Abortion is illegal in Missouri, with some exceptions, such as to save the mother’s life. State law requires a consultation and a 72-hour waiting period. In Kansas, abortion is generally prohibited at 22 weeks’ gestation or later, with a 24-hour waiting period and mandatory consultation.
Passed in 1986, the EMTALA requires hospitals to provide stabilizing treatment to patients with acute illnesses or transfer them to facilities where such care will be provided, regardless of any conflicting state laws or regulations.
Changes in state laws following the U.S. Supreme Court’s decision to end the right to abortion have left many hospitals and health care providers unsure of what steps they can legally take in such cases. HHS published guide confirmed last year that EMTALA requires providers to offer stabilizing care for emergencies that may include abortion.
Hospitals found to be in violation of EMTALA may lose their agreements with Medicare and Medicaid providers and face administrative sanctions. An individual doctor may also face civil sanctions if they are found to be violating the rules.
HHS can impose a fine of $119,942 per violation for hospitals with more than 100 beds and $59,973 for hospitals with fewer than 100 beds. A doctor can be fined $119,942 for a violation.
The National Women’s Law Center says the new actions are the first since Roe v. Wade was upended that EMTALA was used against a hospital that refused an emergency abortion.
“Patient care has been reviewed by the hospital and found to be consistent with hospital policy,” the University of Kansas Health System said in a statement to CNN. “It met the standard of medical care based on the facts known at the time and complied with all applicable laws. CMS has a procedure for dealing with this complaint and we respect that procedure. The University of Kansas Health System follows federal and Kansas laws in providing appropriate, stabilizing, and quality care for all of its patients, including obstetric patients.”
Freeman Hospital did not immediately respond to CNN’s request for comment.
An HHS spokesman told CNN that both hospitals are working to comply with the law.
In a legal center statement, Farmer said she was pleased with the investigation, “but pregnant women across the country continue to be denied medical care and face an increased risk of complications or death, and this must stop. I’ve dealt with an unimaginable loss before, and the hospitals have made things difficult. I’m still emotionally struggling with what happened to me, but I’m determined to keep fighting because no one else has to go through this.”