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Two hospitals – Freeman Hospital West and University of Kansas Health System – are being investigated by the Centers for Medicare and Medicaid Services, spearheaded by the Health and Human Services, after they denied a patient, Mylissa Farmer, the emergency medical care she needed because it involved an abortion, which is restricted in Missouri and Kansas.
Farmer, a patient who was nearly 18 weeks pregnant when she experienced preterm premature rupture of membranes (PPROM), went to Freeman Hospital West in Joplin, Mo., and the University of Kansas Health System in Kansas City, Kan., for help.
In some cases, a woman with PPROM may be able to have a medical abortion, which involves taking medication to end the pregnancy. In other cases, a surgical abortion may be necessary. The risks and benefits of abortion for women with PPROM will vary depending on the individual woman’s circumstances.
It is unclear which option Farmer chose.
Missouri and Kansas have some of the strictest abortion laws. In Missouri, abortion is illegal after eight weeks of pregnancy, with no exceptions for rape or incest. In Kansas, abortion is legal up to 22 weeks of pregnancy, but there are a number of restrictions in place, including a parental consent requirement for minors and a waiting period of 24 hours.
Centers for Medicare and Medicaid Services alleges that the hospitals “did not offer necessary stabilizing care to an individual experiencing an emergency medical condition, in violation of the Emergency Medical Treatment and Labor Act (EMTALA),” CNN reported.
Under EMTALA, it is required health care professionals to “offer treatment, including abortion care, that the provider reasonably determines is necessary to stabilize the patient’s emergency medical condition,” U.S. Health and Human Services (HHS) Secretary Xavier Becerra wrote in a letter on May 1 to national hospital and provider associations.
The U.S. Supreme Court decision that overturned the right to abortion has left many hospitals and providers without guidance on whether or not it is legal to provide care in such cases. However, HHS issued guidance last year reaffirming that EMTALA requires providers to offer stabilizing care in emergency situations, which could include abortion, CNN reported.
“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,” Becerra wrote.
Violating the EMTALA could lead hospitals to lose their Medicare and Medicaid provider agreements and face civil penalties, and individual physicians could also face civil penalties if found to be in violation.
HHS could 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 physician could be fined $119,942 per violation.
PPROM is a condition in which the amniotic sac ruptures (breaks) before 37 weeks of pregnancy, leading to infection and other complications for the mother and baby.
PPROM’s exact cause is unknown, but one of the factors that may increase the risk is a woman’s age or previous pregnancies.