Dr. Carmen Purl and Texas Sue HHS Over 2024 Final Rule on Child Abuse Reporting

On October 21, 2024, Dr. Carmen Purl, alongside her practice Dr. Purl’s Fast Care Walk-In Clinic, filed a lawsuit against the Department of Health and Human Services (HHS), Secretary Xavier Becerra, the Office for Civil Rights (OCR), and OCR Director Melanie Fontes Ranier. The lawsuit asserts that the 2024 Final Rule exceeds HHS’s regulatory authority and hinders Dr. Purl’s duty to report suspected child abuse, violating the Administrative Procedures Act. This legal challenge follows a similar lawsuit by the State of Texas in September 2024, which seeks to invalidate both the 2024 Final Rule and the 2000 Privacy Rule.

Court Orders Preliminary Injunction Against 2024 Final Rule

On December 22, 2024, the U.S. District Court for the Northern District of Texas (Kacsmaryk, J.) issued a preliminary injunction halting enforcement of the 2024 Final Rule against Dr. Purl and her clinic. The court ruled that the plaintiffs demonstrated sufficient evidence of irreparable harm and a likelihood of success on the merits to warrant the injunction.

Court Conclusions on the 2024 Final Rule

The court reached several key conclusions regarding the legality and implications of the 2024 Final Rule:

• The rule imposes unnecessary limitations on state laws intended for child abuse reporting, contradicting HHS’s statutory authority. According to 42 U.S.C. § 1320d-7(b), HIPAA should not limit existing reporting laws.
• The requirement for healthcare providers to navigate complex legal decisions under the Final Rule potentially hampers mandated child-abuse reporting. The court argued that doctors and healthcare entities lack the necessary expertise to interpret the rule.
• The rule inherently hinders and impairs child-abuse reporting, as HHS and OCR admitted.

Impact of the Preliminary Injunction

The preliminary injunction safeguards Dr. Purl and her practice from potential compliance costs and potential violations of Texas child-abuse reporting laws. Conversely, it imposes minimal inconvenience on the defendants. Importantly, the court emphasized that the Privacy Rule already safeguards all sensitive medical information, including reproductive healthcare data, without the need for additional restrictions.

Further Court Action Required

The court ordered further briefing to address several key legal questions. These include:

• The impact of the Supreme Court’s decision in Loper Bright Enterprises v. Raimondo, 144 S. Ct. 2244 (2024);
• The major questions doctrine;
• The nondelegation doctrine.

Additionally, the court requested additional information on the vagueness of the regulation’s definition, particularly regarding the interpretation of reproductive healthcare.

Legal Team Contact Information

For those with questions or concerns regarding this legal alert, you can reach out to Alexandra P. Moylan, Alisa Chestler, Mike Halaiko, E. Bahati Mutisya, or any member of Baker Donelson’s Health Law team.

Conclusion

The lawsuit and subsequent preliminary injunction highlight the ongoing debates around healthcare regulations and their impact on medical professionals’ ability to comply with reporting requirements. As this case progresses, it may set important precedents for future legal challenges to regulatory actions by HHS and OCR.

We encourage you to stay informed on this developing legal landscape. If you have thoughts or questions, please leave a comment below. Subscribe to our newsletter to receive updates on similar cases and legal developments.

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