Just a day after setting up a new religious freedom office, HHS released a sweeping proposed rule that will require Medicare and Mediciad providers to create standards and procedures to protect their employees' religious and moral beliefs.
The rule released Friday largely reiterated the current laws and regulations on the books that protect a medical provider's rights to refuse to perform certain procedures that conflict with their faith or morals. The CMS also issued a notice Friday that revoked an Obama-era Medicaid guidance that banned states from withholding funds from providers that perform abortions.
Citing confusion over conscience laws and their application, HHS outlined some new standards that providers will need to follow, including notifying the public, patients and employees about how federal conscience and associated anti-discrimination statutes apply to them.
The HHS rule implementation will cost $312 million in the first year and $125 million annually in years two through five of the rollout.
If finalized, providers will have to maintain records, cooperate with HHS investigations, submit written assurances and certifications of compliance to faith and moral based anti-discrimination laws and regulation. HHS' newly created Conscience and Religous Freedom Division within its Office of Civil Rights will oversee complaints from providers that feel their rights have not been respected.
If providers don't comply with the conscience regulations, they could lose federal funding going forward as well as retroactively. The violations could also be referred to the Department of Justice, depending on the severity.
HHS said it issued the rule after hearing reports of healthcare providers being asked and made to perform abortion, sterilization or euthanasia procedures despite their faith and moral objections.
The proposed rule also outlines new standards that define whether a provider is participating in an abortion or not. The rule would allow providers to decline to give abortion referrals to patients or inform them about available funding for abortions.
The agency will accept comments on the proposal through March 26.
The CMS simultaneously notified Medicaid directors that it rescinded a 2016 guidance prohibiting states from cutting medical providers' funding because they might also provide abortion services.
"Providing the full range of women's health services neither disqualifies a provider from participating in the Medicaid program, nor is the provision of such services inconsistent with the best interests of the beneficiary, and shall not be grounds for a state's action against a provider in the Medicaid program," the notice said.
The Trump administration said that the Obama administration overstepped its authority with the original guidance.
"We are concerned that the 2016 letter raises legal issues … and limited states' flexibility with regard to establishing reasonable Medicaid provider qualification standards," CMS' Medicaid Director Brian Neale said in a notice Friday.
