Patients who say they were denied emergency abortions and other emergency care can now file complaints directly with the federal government, officials announced Tuesday.
Officials from the Biden administration say that overhauling the process — which historically has been led by state agencies and involved a complex series of decisions — will expedite the federal government’s ability to investigate patients’ complaints and provide more transparency into emergency care access.
Federal officials also highlighted that patients have a right to emergency health care and have created a web portal for them to send complaints directly to the Centers for Medicare and Medicaid Services, which enforces the federal emergency care law, rather than to a state agency.
“We want to make sure that everyone knows their rights and can take action to help make sure the health care system is safe for everyone,” CMS Administrator Chiquita Brooks-LaSure said in a statement.
Under the Emergency Medical Treatment and Labor Act — a nearly 40-year-old federal law known as EMTALA — hospitals receiving federal funds must stabilize or transfer patients needing emergency care. Hospitals must provide the care regardless of the patient’s insurance status, mental illness or other complications that might otherwise lead hospitals to turn them away. If patients believe they were wrongly turned away, they can file a complaint, a process that can trigger a state-federal investigation and threaten the hospital’s funding.
For years, those patients’ complaints have been routed to state health agencies, which conducted investigations and helped determine whether a hospital broke the law. But federal officials and some advocacy groups have increasingly scrutinized the often opaque EMTALA process, questioning how the procedure of filing a complaint can vary state to state, whether it involves too many steps and why some complaints have been rejected.
The decades-old EMTALA process has received fresh attention given the surge of patient complaints about denied emergency abortions following the Supreme Court’s 2022 decision overturning Roe v. Wade, which guaranteed a national right to abortion. Physicians and hospital leaders have said they are confused about whether new state abortion restrictions take precedence over the federal emergency care law, with federal and state leaders offering conflicting guidance. While Biden officials maintain that EMTALA provides protections for emergency abortions, Republican lawmakers have said the law is being wrongly applied.
The Supreme Court is weighing the legal arguments around EMTALA and abortion and expected to render a verdict this year.
The fight over EMTALA and abortion has created a dynamic in which health agencies in conservative states — sometimes overseen by political appointees who oppose abortion — are charged with investigating patients’ allegations that they were denied the procedure. Federal officials have suggested the dynamic may hinder investigations.
It is not clear how many EMTALA complaints are filed each year, with many privately investigated and resolved without being publicly posted in federal databases. Officials at CMS and the Department of Health and Human Services have repeatedly declined to offer details on those investigations, saying it would violate the confidentiality of the process.
Biden officials have said patients may not be aware they can file complaints, noting that some who said they were denied emergency abortions also said they didn’t know a federal law could have provided them with protections to receive the procedures. Federal officials also have said they often are unaware of denied abortions and other sensitive procedures until they receive media coverage, sometimes months later.
Biden officials said they are increasing outreach to patients and providers, pointing to new training materials for heath-care workers and to a dedicated team of experts established to work with hospitals and other providers on EMTALA compliance.
“We will continue to uphold the law and the right to emergency care, to inform people of their rights under EMTALA, and to make it easier for someone denied care to file a complaint,” HHS Secretary Xavier Becerra said in a statement.
Dan Diamond, The Washington Post (May 21, 2024 at 11:00 a.m. EDT)
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