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<section article="ghg" article_name="Health - General" number="19-342.1" title_number="19" title_name="Health Care Facilities" subtitle_number="3" subtitle_name="Hospitals and Related Institutions">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Emergency pregnancy–related medical condition” means a medical condition that presents in a pregnant patient through acute symptoms of sufficient severity and for which the absence of immediate medical attention could be reasonably expected to result in:</text>
      <level label="i">
        <text>Placing the health of the patient in serious jeopardy;</text>
      </level>
      <level label="ii">
        <text>Serious impairment to bodily functions; or</text>
      </level>
      <level label="iii">
        <text>Serious dysfunction of any bodily organ or body part.</text>
      </level>
    </level>
    <level label="3">
      <text>“Stabilize” means, for an emergency pregnancy–related medical condition, to provide the medical treatment necessary to alleviate the condition or ensure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the patient from the facility.</text>
    </level>
  </level>
  <level label="b">
    <text>This section applies only to a hospital with an emergency department.</text>
  </level>
  <level label="c">
    <text>If a hospital determines that a patient has an emergency pregnancy–related medical condition, the hospital shall:</text>
    <level label="1">
      <text>Using the staff and facilities available to the hospital, provide further examination and the treatment required to stabilize the emergency pregnancy–related medical condition, including the termination of a pregnancy when the termination is medically necessary to stabilize the patient; or</text>
    </level>
    <level label="2">
      <text>Transfer the patient to another medical facility.</text>
    </level>
  </level>
  <level label="d">
    <text>A hospital shall allow the termination of a pregnancy at the hospital if the patient’s treating health care practitioner determines termination is medically necessary to stabilize a patient.</text>
  </level>
  <level label="e">
    <level label="1">
      <text>A hospital is considered to have met the requirements of this section if, after offering further examination and treatment or transfer to the patient or the patient’s representative and informing the patient or patient’s representative of the risks and benefits of further examination and treatment or transfer:</text>
      <level label="i">
        <text>A patient or the patient’s representative refuses to consent to further examination and treatment; or</text>
      </level>
      <level label="ii">
        <text>A patient or the patient’s representative refuses to consent to a transfer to another medical facility.</text>
      </level>
    </level>
    <level label="2">
      <text>A hospital shall take reasonable steps to secure written informed consent to the refusal of an examination or treatment or transfer under this subsection from the patient or the patient’s representative.</text>
    </level>
  </level>
  <level label="f">
    <text>If a patient has an emergency pregnancy–related medical condition that has not been stabilized, the hospital may not transfer the patient unless the transfer is done consistent with 42 U.S.C. § 1395dd.</text>
  </level>
  <level label="g">
    <text>A hospital may not penalize or take other adverse action, including an action related to discharge, promotion, demotion, suspension, compensation, training opportunities, staff privileges, or admitting privileges, against:</text>
    <level label="1">
      <text>A treating health care provider if the provider refuses to authorize the transfer of a patient with an emergency pregnancy–related medical condition that has not been stabilized;</text>
    </level>
    <level label="2">
      <text>A treating health care provider if the provider’s treatment of the patient is consistent with the medical standards of care that, in the provider’s clinical judgment, were necessary to stabilize the patient; or</text>
    </level>
    <level label="3">
      <text>A hospital employee if the employee reports a violation of this section.</text>
    </level>
  </level>
  <level label="h">
    <text>A hospital that negligently violates this section is subject to a civil penalty of:</text>
    <level label="1">
      <text>For a hospital with 100 or more beds, not more than $50,000 for each violation; or</text>
    </level>
    <level label="2">
      <text>For a hospital with fewer than 100 beds, not more than $25,000 for each violation.</text>
    </level>
  </level>
  <level label="i">
    <level label="1">
      <text>The Department shall stay a final decision on a potential violation if there is an ongoing federal investigation under 42 U.S.C. § 1395dd regarding the same incident.</text>
    </level>
    <level label="2">
      <text>If a federal investigation under 42 U.S.C. § 1395dd results in a fine being imposed for the same incident, the Department shall subtract the amount of the federal fine from the maximum potential fine under this section for the same incident.</text>
    </level>
    <level label="3">
      <level label="i">
        <text>Subject to subparagraph (ii) of this paragraph, if a federal investigation under 42 U.S.C. § 1395dd results in a fine being imposed for the same incident within 2 years after the Department imposes a fine under this section, the Department shall refund the hospital an amount equal to the amount of the federal fine.</text>
      </level>
      <level label="ii">
        <text>The amount refunded under subparagraph (i) of this paragraph may not exceed the amount of the fine imposed by the Department for the same incident.</text>
      </level>
    </level>
  </level>
</section>
