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HHS Issues Final Rule on Conscience Provisions

By Joanne Kaldy / May 7, 2019

Healthcare employees will be able to refuse some procedures, services due to faith-based objections.

Last week, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) announced the issuance of a final rule on conscience provisions that enables healthcare employees to refuse certain medical procedures—including abortion, sterilization, and even advance directives–if they have faith-based objections. This rule replaces a 2011 regulation that, according to HHS, “has proven inadequate.”

The final rule clarifies what covered entities (including federal agencies and programs, as well as state and local governments receiving federal funds) need to do to comply with applicable conscience provisions and requires applicants for HHS federal financial assistance to provide assurances and certification of compliance. The rule also specifies compliance obligations for covered entities, including cooperation with OCR, maintenance of records, reporting, and non-retaliation requirements. The rule includes healthcare entities and employees, healthcare professionals, and individuals in an HHS-funded health service or research activity. It also applies to patients “who object to certain procedures, including screenings and mental health treatment of children or occupational illness testing, and in other specific instance….” HHS has also issued rules that exempt certain entities from the Affordable Care Act’s contraceptive mandate if they have objections based on religious or moral grounds.

While OCR director Roger Severino says that the “protecting conscience and religious freedom…fosters greater diversity in healthcare,” the final rule has received mixed reactions. While some religion-affiliated groups, such as The Catholic Association, support it, organizations representing the LGBTQ community and others have express concerns. For instance, Human Rights Campaign government affairs director David Stacy said that the rule “threatens LGBTQ people by permitting medical providers to deny critical care based on personal beliefs” and suggested that it puts these individuals at greater risk of being denied necessary and appropriate healthcare.

Already, there is at least one federal lawsuit against the final rule. The city of San Francisco filed a suit asking a judge to block it from taking effect and declare it unconstitutional. HR professionals should keep their eye on this issue as it develops. In the meantime, your organization should prepare for compliance and ensure that you have policies that address these issues. Read more about the final rule here.

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