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Settlements resulting from Emergency Medical Treatment and Labor Act (EMTALA) violations declined 87% between 2002 and 2015, according to a recent analysis.1 Some key findings:
EMTALA’s status as an unfunded mandate and efforts to repeal the Affordable Care Act threaten the financial viability of safety-net hospitals, researchers warn, which could lead to more EMTALA violations.
When EMTALA first became law in 1986, “we all had a very healthy understanding and respect for the law. I have found over the years that this has diminished,” says Heather L. Brown, DMSc, PA-C. Brown, CEO of HL Brown and Associates in Roswell, GA, recently co-authored a paper on the history that led to the enactment of EMTALA.2
“There is misinformation and lack of education on EMTALA,” Brown says. Steep civil monetary penalties can result from violations. “Anyone working in patient care in the emergency medicine arena should be familiar with the law’s do’s and don’ts in order to stay on the correct side of this federal statute,” says Brown, who asks ED providers to keep the following in mind:
A common misconception: EMTALA applies to off-campus urgent care centers or physician offices. Sometimes, staff from the urgent care center wrongly believe that it is a violation to send a patient to the ED for evaluation without calling first to give a report or without getting acceptance for the patient to come. Likewise, staff from clinics sometimes think that informing a patient that their insurance is not accepted is an automatic EMTALA violation. This is not true.
If the patient has presented for care at the ED, he or she needs to be given the screening exam and treatment to stabilization, not encouragement to seek care elsewhere. “If a patient comes to the ED — by the definition, they get screened and stabilized, or the ED could be in violation,” Brown says.
Well-meaning ED staff might encourage a patient to see their primary care physician because the wait is too long or the bill will be less for an outpatient location. “The look of impropriety or coercion would not be favorable for a facility and/or provider who is investigated for a complaint,” Brown warns. n
Financial Disclosure: Kay Ball, PhD, RN, CNOR, FAAN (Nurse Planner), is a consultant for Ethicon USA and Mobile Instrument Service and Repair. The following individuals disclose that they have no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study: Arthur R. Derse, MD, JD, FACEP (Physician Editor), Stacey Kusterbeck (Author), Jonathan Springston (Editor), Jesse Saffron (Editor), Amy M. Johnson, MSN, RN, CPN (Accreditations Manager), and Leslie Coplin (Editorial Group Manager).