Recent changes in federal immigration enforcement practices have prompted renewed attention to how healthcare providers manage requests from law enforcement agencies. While federal policy continues to recognize healthcare facilities as sensitive environments, there has been increased interest in enforcement activity in or around such locations. Healthcare organizations should consider taking this opportunity to review internal protocols and confirm they are prepared to respond in a manner that is consistent with applicable federal and state law.
This post outlines key considerations related to patient privacy, facility access, and provider obligations when immigration enforcement activity intersects with clinical operations.
Patient Privacy and Requests for Information
Healthcare providers remain subject to the requirements of the Health Insurance Portability and Accountability Act (HIPAA), which generally prohibits the disclosure of protected health information (PHI) without patient authorization, except in limited circumstances. One such exception is when disclosure is required by law—for example, pursuant to a valid court order or a judicial warrant.
Providers should be aware that administrative warrants issued by immigration authorities alone typically do not meet HIPAA's "required by law" standard. In such instances, providers should consider verifying whether the request is supported by sufficient legal authority before disclosing patient information. Internal policies and staff training may help ensure that any disclosures are appropriately limited in scope and consistent with federal and state privacy laws.
Facility Access and On-Site Enforcement Activity
In some cases, immigration officials or other law enforcement personnel may seek to enter a healthcare facility to interview or take custody of an individual. Providers should consider preparing for such scenarios by identifying points of contact for handling law enforcement inquiries, establishing protocols for reviewing documentation, and confirming when legal counsel should be contacted.
Importantly, hospitals and other emergency care providers remain obligated to comply with the Emergency Medical Treatment and Labor Act, which requires the screening and stabilization of patients seeking emergency care, regardless of their background or circumstances.
Nondiscrimination and Access to Care
Providers that participate in Medicare or Medicaid are also subject to federal nondiscrimination requirements under the Civil Rights Act and Section 1557 of the Affordable Care Act, as well as state civil rights laws. These laws generally prohibit denying care on the basis of national origin or perceived immigration status. Healthcare organizations may wish to review their policies to ensure they reflect these ongoing obligations.
State and Local Considerations
In addition to federal law, healthcare providers should consider any applicable state or local requirements related to law enforcement interactions, patient rights, or data privacy. Several state attorneys general and regulatory agencies have issued advisories or guidance materials to assist providers in navigating these issues. For example, Maryland's attorney general released guidance for Maryland providers in light of the recent policy changes on immigration enforcement. Reviewing such materials in consultation with counsel may help organizations develop compliant, well-informed operational protocols.
Conclusion
As enforcement practices evolve, healthcare providers would benefit from reviewing their procedures for responding to law enforcement activity—particularly in contexts involving patient privacy, facility access, and legal process. A proactive approach can help ensure compliance with relevant laws and support the delivery of uninterrupted, nondiscriminatory care.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
