Texas Doctor Sues HHS to Prevent Enforcement of Reproductive Health Care Privacy Rule
A lawsuit has been filed against the Department of Health and Human Services (HHS), HHS Secretary Xavier Becerra, the Office for Civil Rights (OCR), and OCR Director Melanie Fontes Rainer over the recent update to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to strengthen reproductive health care privacy.
The HIPAA Privacy Rule to Support Reproductive Health Care Privacy Final Rule was published in the Federal Register on April 26, 2024, took effect on June 25, 2024, and the compliance date is December 23, 2024. The new rule was introduced to strengthen privacy protections for reproductive healthcare information and prevent HIPAA-regulated entities from disclosing reproductive health care information to law enforcement when that information is sought to investigate or impose liability on individuals or healthcare providers for seeking, obtaining, or providing legal reproductive health care.
The lawsuit was filed by attorneys from Alliance Defending Freedom in the United States District Court for the Northern District of Texas, Amarillo Division, naming Carmen Purl, M.D. and Carmen Purl M.D., PLLC as plaintiffs, who do business as Dr. Purl’s Fast Care Walk-In Clinic in Northern Texas. The lawsuit seeks declaratory and injunctive relief against the enforcement of the final rule by the HHS.
The lawsuit alleges the new rule is unlawful and illegally restricts how doctors can protect their patients from abuse. Under Texas law, doctors are required to report suspected abuse to state officials; however, the lawsuit alleges that the 2024 rule limits the circumstances when doctors can disclose reproductive health care information to state child welfare agencies and law enforcement agencies.
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The definition used by the HHS for “reproductive health care” includes abortion care, and this was the main reason why the rule was introduced – due to the overturning of Roe v, Wade which removed the federal right to abortion. The new rule prevents doctors from disclosing information about abortion care that is provided legally to government agencies in states that have restrictions on abortions that seek that information to investigate or impose liability.
The broad definition of reproductive health care means it also covers hormone and drug interventions for gender transition/gender dysphoria, as well as surgical procedures on an individual’s reproductive system, which may include surgery as a treatment for gender dysphoria. Certain states, including Texas, have introduced bans on these procedures on minors.
The lawsuit argues that from December 23, 2024, the plaintiff could be prevented from reporting abuse indicators to state officials such as when a minor is seeking an abortion or has contracted a sexually transmitted disease. The lawsuit also alleges the 2024 rule will prevent the plaintiffs from submitting reports to state officials when an individual has received illegal gender dysphoria procedures such as being prescribed cross-sex hormones or has undergone sex-change surgery. “Medical interventions attempting “gender transition” are categorically harmful to the patient, and can alter a person’s healthy body, cause harmful side effects, and worsen or prolong the mental health symptoms associated with gender dysphoria,” argues Dr. Purl in the lawsuit. Dr. Purl also believes that elective abortion is harmful to the mother as well as the unborn child, and both the mother and unborn child are her patients and both entitled to care.
Dr. Purl and her clinic wish to comply with state laws, but after December 23, 2024, doing so in the cases indicated above would violate the HHS rule and would put her and her clinic at risk of financial costs for non-compliance. The lawsuit alleges a violation of of APA, 5 U.S.C. § 706(2)(C) as the rule is in excess of statutory jurisdiction or authority and a violation of APA, 5 U.S.C. § 706(2)(A) as the rule is arbitrary, capricious, abuse of discretion, and not in accordance with law. The lawsuit seeks a stay and preliminary injunctive relief preserving the plaintiffs’ status and rights while the case is pending, and for the court to hold the HHS rule unlawful, set it aside, and permanently enjoin the defendants from enforcing the rule.
The lawsuit follows a similar lawsuit filed by the Texas Attorney General that seeks to prevent the HHS from enforcing the rule in the state of Texas, as the Texas Attorney General alleges the 2024 rule would illegally restrict the state’s investigations and enforcement of state laws.
