Concerns over Medical Necessity and Approval Process
A recent investigation conducted by the Office of the Inspector General (OIG) has shed light on whistleblower claims regarding unapproved surgeries in Immigration and Customs Enforcement (ICE) facilities. These claims, which initially caused widespread outrage in 2020, accused a doctor of being a “uterus collector” and referred to one facility as an “experimental concentration camp.”
Lack of Approval Raises Questions
The OIG examined 533 major surgical procedures conducted between fiscal years 2019 and 2021. It was discovered that a significant number of these procedures had not received the necessary approvals from the required directors. This raises concerns about the medical necessity of these surgeries and the adherence to proper protocols.
Insufficient Documentation for Hysterectomies
The OIG also contracted an obstetrician/gynecologist (OB/GYN) to evaluate the necessity of surgeries. The OB/GYN found that there was insufficient documentation to support the medical necessity of two out of the six hysterectomies performed on detained non-citizens.
Guidance and Approval Process Lacked Clarity
The investigation revealed that the lack of clearly defined requirements and vague guidance contributed to surgeries being approved through informal means, such as email or verbal communication. This led to a failure in proper review and approval procedures. In response, the IHSC has implemented a policy to ensure all procedures are reviewed and approved through the appropriate system, as recommended by the OIG.
ICE’s Commitment to Medical Care and Updated Policies
In a statement, ICE emphasized its commitment to providing appropriate medical care and treating individuals in custody with respect and dignity. The agency concurs with the OIG report and acknowledges the need for updated policies regarding the IHSC.
ICE spokesperson stated, “IHSC’s current policies now require Regional Clinical Directors and Clinical Directors to document their review and approval of major surgical procedures in IHSC’s electronic health records system. Planned major surgical procedures already require prior authorization review and approval documentation by either a Clinical Director, Regional Clinical Director, or their designee, pursuant to directives published on Dec. 19, 2022.”
Broader Context and Implications
This report comes at a time when the United States is grappling with a crisis at the southern border, with a record number of encounters in December reaching 302,000. As part of a supplemental funding package, additional funding for ICE detention beds is being sought. However, negotiations on the funding deal have hit a roadblock, as Republicans are calling for limits on asylum and the use of parole.
