Lawmakers push GAO to review 'unnecessary surgeries' performed on migrants

A trio of lawmakers is asking the Government Accountability Office to take up an investigation of medical care provided to migrants in detention facilities, knocking an earlier report they say failed to thoroughly review “unnecessary surgeries.”

The ask, led by Rep. Jamie Raskin (D-Md.), the top Democrat on the House Oversight Committee, comes after a string of reports detailing inadequate medical care in some cases, while in other instances invasive surgeries like hysterectomies were performed on migrants who were in U.S. Immigration and Customs Enforcement Authority (ICE) custody. 

An earlier review by the Office of Inspector General (OIG) at the Department of Homeland Security examined case files for six hysterectomies provided to women in ICE custody, finding two “did not include documentation to support a conclusion that a hysterectomy was medically necessary.” It’s not clear how many total hysterectomies were performed in the two-year period reviewed by OIG.

“Earlier this year, the Department of Homeland Security Office of Inspector General issued a report entitled ‘ICE Major Surgeries Were Not Always Properly Reviewed and Approved for Medical Necessity.’ Despite the title of the report, the Office of the Inspector General’s nearly four year review was unable to conclusively determine whether detainees are experiencing medically unnecessary surgeries, including hysterectomies and other procedures that may have minimally invasive alternatives.

The study also did not evaluate whether patients received informed consent prior to surgery or differentiate emergency and non-emergency surgeries,” the lawmakers wrote in the letter, which was also signed by Rep. Robert García (D-Calif.) and Rep. Alexandria Ocasio-Cortez (D-N.Y.). 

“In light of these concerns, we request that GAO do a more fulsome and rigorous review.”

GAO confirmed receipt of the letter and will formally review the request.

Concern over unnecessary hysterectomies came after a nurse who worked at an ICE facility in Georgia blew the whistle on a doctor they alleged removed women’s uteruses without their consent. 

An earlier review done in a joint effort from the House Oversight and Homeland Security Committees found the doctor may have performed unnecessary and invasive procedures on patients to inflate payment from the government.

“My concern is that he was not competent and simply did the same evaluation and treatment on most patients because that is what he knew how to do, and/or he did tests and treatments that generated a significant amount of reimbursement without benefiting most patients,” wrote Tony Ogburn, a doctor asked to review ICE contractor Mahendra Amin’s files.

Central to the lawmakers request for the probe is obtaining informed consent from detainees, as well as ensuring they “are able to make competent and voluntary decisions about whether to undergo major surgery.”

“Do ICE and [U.S. Customs and Border Protection] have adequate safeguards in place to ensure that detainees are undergoing medically necessary surgeries and less invasive alternatives are offered where appropriate?” the lawmakers ask.

The request also asks for GAO to review access to translators or medical professionals that speak migrants' language.

The lawmakers ask GAO to likewise probe barriers preventing migrants from getting needed care, noting various recent incidents in which those in custody were not referred for medical assistance. 

“People in ICE detention have reported incidents of poor or improper medical care while in ICE custody and difficulties obtaining authorization and referrals for appropriate medical care, especially in urgent situations,” they noted.