The federal government, not state political leaders, initiated an Freeman Health Services in Joplin provided after a denying a woman an emergency abortion, a Missouri Department of Health and Senior Services spokeswoman said Monday.
On Aug. 2, Mylissa Farmer came to the emergency room at Freeman Health after her water broke just before the 18th week of her pregnancy. Her physician recommended an emergency abortion but could not perform one because Missouri law prohibits abortions in almost all cases, in a story published Oct. 19.
Farmer received an abortion a few days later at a clinic in Granite City, Illinois, after trying to obtain care in Kansas and Colorado.
Farmer is for Schmitt鈥檚 Democratic opponent in next Tuesday鈥檚 U.S. Senate election, Trudy Busch Valentine, telling her story and blaming her inability to obtain an immediate abortion on Republican Attorney General Eric Schmitt.
Schmitt issued a proclamation June 24 putting and making Missouri the first state to outlaw nearly all abortions after the Supreme Court overturned Roe v. Wade.
Through his attorney, Schmitt has attempted to keep Valentine鈥檚 ad featuring Farmer off the air. No station has dropped it.
The investigation is for possible violations of a federal law requiring hospitals participating in the Medicare program to provide care for patients in emergency situations, health department spokeswoman Lisa Cox said in an email.
The law directs the state health department, as the licensing agency for hospitals, to conduct site visits for investigations when directed to do so by the Centers for Medicare and Medicaid Services.
The investigation is ongoing, Cox said, 鈥渁uthorized by CMS on October 20, regarding the situation you鈥檝e referenced at Freeman in Joplin. This is all we can provide at this time.鈥�
Cox did not respond to questions asking for details about the authorization.
The investigation became public last week in Sunshine Law requests filed by House Democratic Leader Crystal Quade of Springfield, with the department, Gov. Mike Parson鈥檚 office and Schmitt鈥檚 office.
In her letters, Quade said the timing was suspicious and accused Republican officeholders of starting the investigation in retaliation for Valentine鈥檚 ad.
Quade demanded records of communications between the department and the two Republican elected officials, worried that the investigation was intended to protect Schmitt as he seeks a seat in the U.S. Senate in this next week鈥檚 election.
In its response to her, Schmitt鈥檚 office said it had no records showing contacts with the health department about the case, Quade said Monday afternoon. She said she had not received any response from the health department or Parson鈥檚 office.
The news that the investigation was initiated by the federal agency doesn鈥檛 alter the problem Farmer鈥檚 case illustrates, Quade said. Missouri women with pregnancy-related emergencies are going to have difficulty getting appropriate care, she said.
鈥淚 believe we are going to continue to hear more and more stories like this where an individual went to receive care and had to leave the state,鈥� Quade said.
Under Missouri鈥檚 abortion law, passed in 2019, abortions will only be permitted in cases of a medical emergency when 鈥渁 delay will create a serious risk of substantial and irreversible physical impairment of a major bodily function.鈥�
There are no exceptions for rape or incest under the law.
An investigation under the federal law , which can come from patients, family members, healthcare professionals, 鈥渁nd other interested parties.鈥� Once a complaint is deemed worthy of investigation by the CMS regional office, it authorizes the state agency to conduct a site visit.
鈥淎ll investigations are to be unannounced,鈥� a document describing the procedure states.
The investigation must be initiated within two business days of the authorization. If the complaint is substantiated, the report of the investigative team must be submitted to CMS within 10 business days of the visit.
The investigation gathers facts from medical records, patient logs and other hospital documents as well as through interviews of patients, family members and hospital staff.
The state health department is just the fact-gathering agency, and does not have any say in the findings of the investigation, the document states. That job is performed by an expert physician employed by CMS to review investigations.
The issue isn鈥檛 whether the hospital violated a federal law in its treatment of Farmer, Quade said. The problem is that doctors all over the state are unsure what treatments are allowed and which ones could result in criminal charges.
鈥淚 am not worried who is to blame in this situation,鈥� she said. 鈥淚 am worried people aren鈥檛 going to get the care they need.鈥�
This story was originally published by the , part of States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity. Missouri Independent maintains editorial independence.
