Montana physicians and other health professionals in private practice, in hospitals, and in certain federally funded facilities will be able to take necessary steps to stop vaccine-preventable infectious diseases from spreading in their offices thanks to a federal court ruling.

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The court issued a permanent injunction that prevents Montana officials from enforcing a law that bars health professionals from knowing the vaccination status of employees or patients if they refuse to answer questions about vaccination status or immunity passports.

State lawmakers passed the statute in 2021 in response to the COVID-19 pandemic, but the law applied to all vaccines, whether it was for measles, mumps, flu, rubella, tetanus or the like.

The Montana Medical Association (MMA), other medical organizations and patients with compromised immune systems sued the state’s attorney general over the statute because it jeopardized patients’ health, as well as workers’ health, by putting them at risk of being exposed to vaccine-preventable diseases for merely seeking medical care. The Litigation Center of the American Medical Association and State Medical Societies provided assistance in the case (PDF), Montana Medial Association et al. v. Knudsen.

The U.S. District Court for the District of Montana Missoula Division in December agreed with the MMA and other health professionals, ruling that the law is unconstitutional and preempted by federal law. The court further said that the public has a serious interest in a permanent injunction that prohibits the state from enforcing the law in a private health care setting.

“The public interest in protecting the general populace against vaccine-preventable diseases in health care settings using safe, effective vaccines is not outweighed by the hardships experienced to accomplish that interest,” the court said.

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In a statement, the MMA said in a statement that the court’s “conclusion allows doctors to make needed accommodations and medically necessary decisions to create safe environments for patients regardless of their medical challenges.” the statement said.

Thanks to the ruling, the MMA’s statement added, “Montana patients know that when they walk into a health care setting there are policies and procedures in place that will keep them safe.”

Find out more about the cases in which the AMA Litigation Center is providing assistance and learn about the Litigation Center’s case-selection criteria.

The Montana law created “untoward problems” for physicians and other health professionals who are “trying to protect the environment where services to patients are rendered and to prevent the spread of diseases,” the federal court said.

As part of its ruling, the court agreed with the MMA and others that the law violates the Americans with Disabilities Act, which requires employers to consider employees’ requests for accommodation. That includes requests from employees with compromised immune systems.

The court also agreed that physicians need to know their employees’ vaccination status to ensure they aren’t discriminating against their own patients.

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“Even if a health care setting is unable to limit a patient’s exposure to nonimmune staff, the setting still needs to know immunity or vaccination status of employees to offer protection and reduce the risk of exposure through other possible methods such as using specialized personal protective equipment or requiring physical distancing,” the court said.

The court added that the state law violated the federal Occupational Safety and Health Act.

The ruling also made permanent a preliminary injunction that the judge in the Montana case had earlier issued to block the state from enforcing the law at facilities that fall under Centers for Medicare & Medicaid Services (CMS) regulations.

The judge issued the preliminary injunction after the U.S. Supreme Court allowed a CMS vaccine requirement for health care workers at federally funded medical facilities to stand.

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