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Thursday, January 20, 2011

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, but not physicians, may also be sued by private individuals who suffer personal injuries as a result of a violation of EMTALA.

A dispute over the interpretation of the statute has recently arisen in the context of the application of EMTALA to individuals who come to a hospital emergency room and are subsequently admitted to the hospital as inpatients. Regulations promulgated by the Centers for Medicare and Medicaid Services (CMS) have taken the position that a hospital’s EMTALA obligations end once an individual is admitted as an inpatient. However, in Moses v. Providence Hospital, the United States Court of Appeals for the Sixth Circuit held that, despite these regulations, transferring or discharging an inpatient without stabilizing an emergency medical condition could still constitute a violation of EMTALA. Consequently, a hospital’s obligations to inpatients under EMTALA may be modulated by the Moses decision if the hospital happens to be located in the Sixth Circuit’s jurisdiction (Kentucky, Michigan, Ohio, and Tennessee).

In December of 2010, CMS solicited comments on whether CMS’s inpatient regulations should be revisited. The solicited comments may provide specific examples of individuals’ treatment after being admitted from the emergency room, which may be of interest to both agency officials and legislators.

Date of Report: December 28, 2010
Number of Pages: 11
Order Number: RS22738
Price: $29.95

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