Over the past two years, unique religious accommodation rules have created unexpected compliance obligations for healthcare entities. As we previously discussed , healthcare employees and government agencies have brought several claims recently challenging healthcare entities’ mandatory vaccination policies, and claiming that these entities must provide broader accommodations for employees’ religious beliefs. Last week, two court decisions created questions about a similar but separate issue, i.e., when a healthcare employee may decline to care for a patient for religious or moral reasons.

As background, earlier this year, the federal Department of Health and Human Services (HHS) adopted a “conscience protection rule.” This rule would have allowed HHS to strip federal funding from certain hospitals and clinics if they required their employees to provide care in a manner that contradicted the employees’ religious or moral beliefs. This rule immediately generated major controversy. Several entities quickly challenged this rule, and many commentators opined that it would not survive court scrutiny.

Last week, two federal district courts separately vacated the rule. First, the U.S. District Court for the Southern District of New York vacated the rule on several grounds. It held that Congress had not delegated authority to the HHS to issue the rule, and also held that the rule conflicted with several Congressionally enacted laws (including Title VII). Notably, the court struck down the entire rule, rather than attempting to sever and “save” certain portions. Then, two days later, the U.S. District Court for the Eastern District of Washington vacated the rule as being outside of the HHS’s delegated authority. (This second court has not yet issued a full opinion as of the time of this article.)

Although HHS has not yet appealed these decisions, most observers expect them to do so, and the current administration has an established record of appealing adverse district court decisions. In any event, even if this rule remains invalidated, Title VII and certain state and local laws also potentially allow employees to request changes to their job duties on the basis of sincerely held religious beliefs (although, typically, employers will have much more flexibility under these laws than under the HHS rule). Ultimately, healthcare providers should continue to monitor the status of the HHS rule, and they should remember to proceed with caution when employees request certain job changes or other accommodations due to religious or moral beliefs.