Two Midwest hospitals are under federal investigation for potentially violating the federal Emergency Medical Treatment and Labor Act (EMTALA) by allegedly failing to offer appropriate obstetric emergency care.
On Monday, CMS announced investigations into the unnamed hospitals' failures to "offer necessary stabilizing care to an individual experiencing an emergency medical condition" per EMTALA, according to an HHS statement.
The facilities in question are Freeman Hospital West in Joplin, Missouri, and the University of Kansas Health System in Kansas City, according to the National Women's Law Center (NWLC). The Washington-based NWLC is representing the patient, Mylissa Farmer.
"Last August, Ms. Farmer experienced preterm premature rupture of membranes (PPROM) at approximately 18 weeks of pregnancy," the NWLC said in a statement. "This was a medical emergency, putting her at risk of severe blood loss, sepsis, or death. But she was denied the emergency care she needed -- an abortion -- by Freeman Hospital West in Joplin, Missouri, and the University of Kansas Health System in Kansas City, Kansas."
Farmer filed an EMTALA complaint with CMS in November that detailed the devastation she experienced as a result of the mistreatment she said she endured. The complaint stated, in part, that she continues to think of other women who are "being forced to go through what she went through," and that she has "lost faith in the medical providers in her community."
On Monday, HHS Secretary Xavier Becerra referenced the critical nature of emergency care in public remarks on the investigations.
"As we have made explicitly clear: we will use the full extent of our legal authority, consistent with orders from the courts, to enforce protections for individuals who seek emergency care -- including when that care is an abortion," Becerra stated.
"Fortunately, this patient survived," he added. "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."
"The Biden-Harris Administration is committed to patient safety and protecting people's access to the healthcare they need," Becerra's statement continued. "Today, we send a reminder to hospitals participating in Medicare: you are obligated under EMTALA to offer stabilizing care to patients who need emergency care, and we will not hesitate to enforce your obligations under the law."
HHS stated that Becerra sent a letter to hospital and provider associations nationwide to remind them of the professional and legal duty healthcare providers have to offer necessary stabilizing medical treatment, or if appropriate, to transfer a patient.
In the letter, Becerra wrote that recent media reports have "highlighted the troubling experiences of many pregnant women presenting to hospital emergency departments with emergency medical conditions and not being offered necessary stabilizing treatment or being turned away," and that such instances "may be due to uncertainty regarding whether facility administrators may allow providers to follow their reasonable medical judgment in caring for pregnancy-related emergencies as a result of the legal status of abortion care and related obstetric services in their states."
"While many state laws have recently changed, it's important to know that the federal EMTALA requirements have not changed, and continue to require that healthcare professionals offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient's emergency medical condition," the letter stated.
In response to the current situation, a University of Kansas Health System spokesperson emailed the following statement: "The care provided to the patient was reviewed by the hospital and found to be in accordance with hospital policy. It met the standard of care based upon the facts known at the time, and complied with all applicable law. There is a process with CMS for this complaint and we respect that process. The University of Kansas Health System follows federal and Kansas law in providing appropriate, stabilizing, and quality care to all of its patients, including obstetric patients."
Freeman Health System did not immediately respond to a request from MedPage Today for comment.
After the Supreme Court overturned Roe v. Wade, one expert told MedPage Today that EMTALA, a law enacted in 1986, could be a potential loophole for doctors to provide abortion-related care. EMTALA requires emergency departments that receive Medicare or Medicaid funding to stabilize patients.