House Bill 1099

AN ACT TO BE KNOWN AS THE EMERGENCY MEDICAL CARE CLARITY ACT; TO PROVIDE THAT A HOSPITAL SHALL PROVIDE AN APPROPRIATE MEDICAL SCREENING EXAMINATION AND EMERGENCY MEDICAL SERVICES TO ANY INDIVIDUAL WHO COMES TO THE EMERGENCY DEPARTMENT AND REQUESTS EXAMINATION OR TREATMENT, OR HAS SUCH A REQUEST MADE ON THEIR BEHALF, TO DETERMINE WHETHER AN EMERGENCY MEDICAL CONDITION EXISTS; TO PROVIDE THAT IF AN EMERGENCY MEDICAL CONDITION IS IDENTIFIED, THE HOSPITAL AND ITS MEDICAL STAFF SHALL HAVE A DUTY OF CARE TO PROVIDE STABILIZING TREATMENT WITHIN THEIR CAPABILITY AND CAPACITY; TO PROVIDE THAT EMERGENCY MEDICAL SERVICES OR STABILIZING TREATMENT SHALL NOT BE DELAYED OR DENIED FOR NON-MEDICAL REASONS; TO PROVIDE THAT IF A PATIENT HAS RECEIVED AN APPROPRIATE MEDICAL SCREENING EXAMINATION, AND THE EXAMINING HEALTH CARE PROVIDER DETERMINES THAT AN EMERGENCY MEDICAL CONDITION EXISTS AND THE CONDITION HAS NOT BEEN STABILIZED, THE HOSPITAL SHALL NOT TRANSFER THE PATIENT UNLESS CERTAIN CONDITIONS ARE MET; TO PROVIDE THAT THE ATTORNEY GENERAL AND THE STATE DEPARTMENT OF HEALTH MAY INVESTIGATE AND BRING A CIVIL ACTION AGAINST ANY HOSPITAL OR PROVIDER WHO VIOLATES THIS ACT; TO PROVIDE THAT ANY INDIVIDUAL WHO SUFFERS HARM FROM A VIOLATION OF THIS ACT MAY BRING A CIVIL ACTION IN A COURT OF COMPETENT JURISDICTION FOR COMPENSATORY AND PUNITIVE DAMAGES AND EQUITABLE RELIEF; TO PROVIDE THAT HOSPITALS MAY NOT PENALIZE PROVIDERS WHO STABILIZE PATIENTS CONSISTENT WITH MEDICAL STANDARDS OF CARE; TO PROVIDE THAT HOSPITAL EMPLOYEES ARE PROTECTED FROM RETALIATION FOR REPORTING VIOLATIONS; TO PROVIDE THAT HOSPITALS WITH SPECIALIZED FACILITIES MUST ACCEPT APPROPRIATE TRANSFERS IF CAPACITY EXISTS; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Short title. This act shall be known and may be cited as the Emergency Medical Care Clarity Act.

SECTION 2. Definitions. As used in this act, the following terms shall be defined as provided in this section, unless the context otherwise requires:

(a) "Emergency medical condition" means:

(i) A medical condition manifesting itself by acute signs and symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the person in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of any bodily organ or part; or

(ii) With respect to a pregnant person who is having contractions, there is inadequate time to effectuate a safe transfer to another hospital before delivery, or that transferring the patient may pose a threat to the health or safety of the patient. For pregnant people, "emergency medical condition" includes, but is not limited to:

1. Active labor;

2. Ectopic pregnancy;

3. Threatened or incomplete miscarriage;

4. Complications resulting from pregnancy or pregnancy loss;

5. Preterm premature rupture of membranes (PROM);

6. Placental abnormalities;

7. Emergent hypertensive disorders, including preeclampsia;

8. Risks to future fertility;

9. Situations where there is inadequate time for safe transfer or transfer poses a threat to patient safety; and

10. Any emergent hypertensive disorder when the absence of immediate medical attention could reasonably be expected to result in placing the health of the person in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part.

(b) "Hospital" means a:

(i) A licensed health care hospital in the state that maintains an emergency department;

(ii) A freestanding emergency department; or

(iii) Any other licensed health care hospital, or area of a hospital or health care hospital, that holds itself out to the public as providing emergency care.

(i) A medical screening examination that is appropriate to the patient's presenting signs and symptoms, conducted by a qualified health care provider acting within their scope of practice to determine if an emergency medical condition exists. For a pregnant patient, the screening may be conducted by an obstetrician, emergency physician, certified nurse midwife, physician assistant, nurse practitioner, or other qualified provider, consistent with hospital resources that is appropriate to the patient's presenting signs and symptoms to determine if an emergency medical condition exists; and

(ii) When an emergency medical condition exists, the medical treatment and care necessary to stabilize the patient as determined by the examining health-care provider.

The term "emergency medical services" include any medically necessary intervention required to stabilize an emergency medical condition, including procedures that may result in pregnancy termination when, in the physician's reasonable medical judgment, such intervention is necessary to prevent the patient's death or serious impairment of a major bodily function.

(d) "Stabilize" or "stabilizing treatment" means to provide medical treatment necessary to ensure, within reasonable medical probability, that no material deterioration of the patient's condition is likely to result from or occur during discharge or transfer.

The term "stabilizing treatment" includes any medically necessary intervention required to stabilize an emergency medical condition, including procedures that may result in pregnancy termination when, in the physician's reasonable medical judgment, such intervention is necessary to prevent the patient's death or serious impairment of a major bodily function.

SECTION 3. Medical screening and stabilization requirements. (1) A hospital shall provide an appropriate medical screening examination and emergency medical services to any individual who comes to the emergency department and requests examination or treatment, or has such a request made on their behalf, to determine whether an emergency medical condition exists.

(2) If an emergency medical condition is identified, the hospital and its medical staff shall have a duty of care to provide stabilizing treatment within their capability and capacity.

(3) Emergency medical services or stabilizing treatment shall not be delayed or denied for non-medical reasons including:

(a) Inability to pay;

          (b) Lack of insurance or public benefits;
          (c) Citizenship or immigration status;
          (d) Pregnancy outcome or status; or
          (e) Personal, institutional or religious beliefs or policies of staff or hospital.

(4) When the termination of a pregnancy is medically necessary to stabilize the patient, the hospital shall not condition such stabilizing treatment on the consent of any individual other than the patient or their legal representative.

SECTION 4. Transfers and discharges. If a patient has received an appropriate medical screening examination as described in this act, and the examining health care provider determines that an emergency medical condition exists and the condition has not been stabilized, the hospital shall not transfer the patient unless all of the following conditions are met:

(a) The transferring hospital must provide any available medical treatment to minimize the risks to the patient's health;

(b) The receiving hospital must have space available, qualified personnel to treat the patient, and agree to accept the individual and provide necessary treatment;

(c) The transferring hospital sends all medical records, or copies of the medical records, related to the patient's emergency medical condition that the patient presented to the hospital for, that are available at the time of the transfer, including medical records, or copies of the medical records, related to observations of signs and symptoms; preliminary diagnosis; treatment provided to the patient; test results; the informed written request or certification provided pursuant to this section; and, if relevant, the name and address of any on-call physician who refused or failed to appear at the hospital within a reasonable amount of time to provide the patient with necessary stabilizing treatment;

(d) The transfer is effected through qualified personnel and transportation equipment, including the use of necessary and medically appropriate life support measures during the transfer;

(e) Ater being informed of the risk of transfer, the patient or the patient's representative requests the transfer in writing, and

(f) A physician has signed a certification that includes a summary of the risks and benefits of transferring the patient and a statement that, based upon the information available at the time of the transfer, the medical benefits reasonably expected from the provision of appropriate medical treatment at another hospital outweigh the increased risks to the patient from being transferred.

SECTION 5. Enforcement and remedies. (1) State enforcement: The Attorney General and the State Department of Health may investigate and bring a civil action against any hospital or provider who violates this act. Remedies may include:

(a) Injunctive relief;

(b) Civil penalties of up to Fifty Thousand Dollars ($50,000.00) per violation; and

(2) Private right of action: Any individual who suffers harm from a violation of this act may bring a civil action in a court of competent jurisdiction for:

(a) Compensatory and punitive damages;

(b) Equitable relief; and

(3) No immunity: Hospitals and providers are not immune from liability under this act based on religious or moral objections, nor may they claim immunity under federal conscience protection laws where such objections result in the denial of stabilizing emergency care.

SECTION 6. Whistleblower and provider protections. (1) Hospitals may not penalize providers who stabilize patients consistent with medical standards of care.

(2) Hospital employees are protected from retaliation for reporting violations.

SECTION 7. Specialized capabilities. Hospitals with specialized facilities (e.g., trauma, NICU, maternal-fetal medicine) must accept appropriate transfers if capacity exists.

SECTION 8. This act shall take effect and be in force from and after July 1, 2026, and shall apply to all hospitals and providers operating in the state as of that date.