Disaster Status Exception
For a national emergency or crisis (eg, bioterrorism), state or local governments may develop community response plans that designate specific entities (eg, hospitals and public health facilities) with the responsibility of handling certain categories of patients during these catastrophic events.
Although CMS added a section to the rules eliminating sanctions for inappropriate transfers in these circumstances, hospitals could still be held responsible for providing a MSE to any patients who presented to the ED. For example, a patient potentially exposed to a toxin arrives at a hospital not designated, pursuant to a state or local EMS plan, as a hospital where patients exposed to toxins should go. After interviewing the patient and determining that the patient falls into the category for which the community has a specified screening site, the patient may be referred to the designated community facility without risking sanctions under EMTALA. Also, public employees may not be sanctioned for violations of the Health Insurance Portability and Accountability Act (HIPAA) or EMTALA that occur during a public health emergency (42 USC §1320b-5[b]). It is important to note that this exemption applies only to declared national—not state or local—emergencies.
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