EMTALA: Emergency Medical Treatment and Active Labor Act
The Emergency Medical Treatment and Active Labor Act (or EMTALA) is a federal law passed in 1986 as a part of COBRA, and it deals with the proper care and transfer of emergency patients. Specifically, it requires hospitals to treat all emergency (or potential emergency) patients equally, regardless of their insurance status, income, or other factors.
EMTALA Requirements and Purposes
EMTALA was initially intended to prevent hospitals and practices from transferring uninsured patients for financial reasons, a practice commonly called “patient dumping.” This health law mandates:
- Anyone who comes into a hospital’s emergency department must be given a medical screening examination (MSE) in order to determine if an emergency medical.
- If an EMC exists, the patient must be stabilized or transferred to a hospital with the appropriate capabilities.
- Hospitals with specialized medical services must accept transferred patients who require those services.
While its initial intent was to prevent patient dumping, and even though the wording of the law itself is vague, EMTALA has had far reaching effects as the Centers for Medicare and Medicaid (CMS) and the courts have interpreted the law and enforced it.
Responsibilities of Medical Care Providers
The ramifications of EMTALA have been numerous. Medical care providers have increased responsibility when it comes to the treatment and handling of all patients. Some examples of these responsibilities include:
- Ensuring proper procedures and bylaws are in place throughout the hospital’s campus governing the screening, treatment, stabilization, and transfer of patients.
- Specific protocols on what an MSE will entail to ensure consistency.
- Providing appropriate MSE’s to all who enter the hospital’s premises, even if they don’t go directly to a designated emergency department.
- Maintain appropriate on-call lists and facilities for all departments to make sure the types of care they routinely provide are available.
In addition, under EMTALA, all transfers have potential liability. For instance, if it can be shown that a patient was not “stable” (which is very loosely interpreted under EMTALA) when transferred, it could constitute a violation of the law.