ExecutiveOrdersEO
MemoMemorandumObama · D Quiet signal

Presidential Memorandum

Respecting the Rights of Hospital Patients to Receive Visitors and to Designate Surrogate Decision Makers for Medical Emergencies

This memorandum directs the Secretary of Health and Human Services to initiate rulemaking ensuring that hospitals participating in Medicare or Medicaid allow patients to designate visitors—including same-sex partners and non-family members—with equal visitation rights as immediate family. It also requires enforcement of existing advance directive regulations and requests additional recommendations within 180 days on addressing LGBT patient and family healthcare issues.

Federal Register Open PDF 75 FR 20511

Impact dates

  1. HHS recommendations on LGBT patient and family healthcare issues

Key directives

  • Initiate rulemaking under 42 U.S.C. 1395x to ensure Medicare/Medicaid hospitals respect patient-designated visitors with equal privileges as immediate family
  • Prohibit denial of visitation based on race, color, national origin, religion, sex, sexual orientation, gender identity, or disability
  • Ensure compliance with 42 CFR 482.13 and 42 CFR 489.102(a) on advance directives
  • Issue new guidelines and provide technical assistance on advance directive compliance under 42 U.S.C. 1395cc
  • Provide recommendations within 180 days on actions to address hospital visitation, medical decisionmaking, and other healthcare issues affecting LGBT patients and families

Who is ordered

Timeline

Immediate

  • Publication in Federal Register
  • Rulemaking process initiation requested

Near term (90d)

  • HHS to begin rulemaking on visitation rights
  • HHS to issue new guidelines and technical assistance on advance directive compliance

Long term

  • Final rulemaking implementation
  • HHS recommendations on LGBT healthcare issues due
  • Potential structural change in hospital visitation policies nationwide

Risks & tensions

  • Rulemaking timeline uncertain—no deadline specified for final rule
  • Religious liberty tensions possible regarding faith-affiliated hospitals
  • Medically appropriate restrictions clause creates implementation discretion
  • Non-enforceable disclaimer limits legal recourse for individuals
Presidential Memorandum: Respecting the Rights of Hospital Patients to Receive Visitors and to Designate Surrogate Decision Makers for Medical Emergencies · Executive Orders