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Tuesday, January 26, 2010

EMTALA: Access to Emergency Medical Care

Edward C. Liu
Legislative Attorney


The Emergency Medical Treatment and Active Labor Act (EMTALA) ensures universal access to emergency medical care at all Medicare participating hospitals with emergency departments. Under EMTALA, any person who seeks emergency medical care at a covered facility, regardless of ability to pay, immigration status, or any other characteristic, is guaranteed an appropriate screening exam and stabilization treatment before transfer or discharge. Failure to abide by these requirements can subject hospitals or physicians to civil monetary sanctions or exclusion from Medicare. Hospitals may also be subject to civil liability under the statute for personal injuries resulting from the violation.


In 1986, Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA)1 to address the problem of "patient dumping" in hospital emergency departments. Patient dumping refers to instances in which a hospital turns away indigent or uninsured persons seeking treatment so that the hospital will not have to absorb the cost of treating them. Although attempts to facilitate indigent access to emergency health care already existed in state and federal law, legal frameworks prior to EMTALA were plagued with poor enforcement mechanisms and vague standards of conduct.2 Amid graphic media reports of hospitals sending away critically ill patients without proper stabilization treatment and delivery rooms unwilling to accept indigent or uninsured women in labor, Congress passed EMTALA as part of the Consolidated Omnibus Budget Reconciliation Act of 1985.3 

EMTALA's statutory scheme has traditionally been deconstructed into two principal categories: (1) provisions that ensure an appropriate medical screening, and (2) provisions that require stabilization before transfer or discharge.4 EMTALA only requires stabilization of whatever emergency conditions a hospital detects, and does not provide a right to indefinite care for anyone who comes to an emergency room. EMTALA's requirements may be suspended by the Secretary of Health and Human Services during national emergencies, such as the recent landfall of Hurricane Ike in Texas.5 Hospitals and physicians that fail to comply with these requirements may be fined $50,000 and/or excluded from participation in Medicare, and hospitals may also be held civilly liable to persons who suffer personal injury


Date of Report: January 12, 2010
Number of Pages: 10
Order Number: RS22738
Price: $29.95

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