Emergency Medical Treatment and Active Labor Act
For years, many indigent patients were turned away from hospital emergency departments (EDs). Patients in unstable condition were transferred or denied care simply because they did not have the financial means to make or guarantee hospital payment.
Congress passed an amendment to the Social Security Act, EMTALA, as part of the Consolidated Omnibus Budget Reconciliation Act of 1986. Intended as an “anti-patient dumping” law, it requires Medicare-participating hospitals to provide necessary emergency care for patients regardless of the patient's ability to pay. Subsequent revisions of EMTALA have expanded its scope and better defined its role, especially with respect to EMS. State or federal laws that contradict or conflict with EMTALA are considered preempted by it. The Centers for Medicare and Medicaid Services (CMS) issues and enforces regulations under the act.EMTALA requirements are summarized in the box. Basically, the law provides that any patient who “presents” to the hospital's “dedicated” ED requesting evaluation or treatment must receive a medical screening examination (MSE) to determine the presence of an emergency medical condition (EMC). If an EMC is present, the patient's condition must be stabilized within the capacity of the treating hospital. Patients requiring care beyond the hospital's capacity may be transferred to an appropriate facility. The obligations related to the transfer depend on whether the patient's condition is stable. Protection under EMTALA also covers psychiatric patients and the unborn children of women in labor.
Hospital Requirements Under EMTALA
• Provide an appropriate medical screening examination to any individual who comes to the emergency department
• Provide necessary stabilizing treatment to an individual with an emergency medical condition (EMC) or an individual in labor
• Provide for an appropriate transfer of the individual if either the individual requests the transfer or the hospital does not have the capability or capacity to provide the treatment necessary to stabilize the EMC (or the capability or capacity to admit the individual)
• Not delay examination and/or treatment in order to inquire about the individual's insurance or payment status
• Obtain or attempt to obtain written and informed refusal of examination, treatment or an appropriate transfer in the case of an individual who refuses examination, treatment or transfer
• Not take adverse action against a physician or qualified medical personnel who refuses to transfer an individual with an emergency medical condition, or against an employee who reports a violation of these requirements.
More on the topic Emergency Medical Treatment and Active Labor Act:
- Emergency Medical Treatment and Active Labor Act
- Emergency Medical Communications Systems
- Selected Readings
- Training for Survival and Emergency Conditions
- Health Insurance Portability and Accountability Act
- AAP. Guidelines for Air and Ground Transport of Neonatal and Pediatric Patients. 4th edition. — American Academy of Pediatrics,2015. — 488 p., 2015
- The optimal transport of each neonatal and pediatric patient is facilitated when the personnel involved ensure the appropriate use of available resources, including staff, equipment, and vehicles.
- Emergency of technogenic character
- Ceasing to Act
- Emergency of nature character