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During this presentation, our expert will outline one of the most problematic standards for hospitals from CMS: Emergency Medical Treatment and Labor Act (EMTALA) regulations concerning On-call Physicians. The current CMS deficiency report found more than 2,600 EMTALA deficiencies, and 120+ of them were related to on-call physician issues. The Patient Protection and Affordable Care Act have specific provisions related to insurers and EMTALA-covered patients. It is essential that every hospital and critical access hospital follow the federal law and CMS interpretive guidelines on EMTALA to guarantee uninterrupted reimbursements and avoid penalties.
Individual physicians can be fined and excluded from participating in any federal program and their license revoked by the state medical board. CMS and the Office of Inspector General (OIG) suggest that hospitals provide EMTALA on-call training for their physicians who are on call. Is your hospital and doctor training up-to date?
|- CMS guidelines||- Provider agreements||- EMTALA law|
|- Relevant factors||- Policy & procedures||- OIG bulletins|
|- Shared-call plans||- Maintaining on-call list||- False labor|
|- Guidance memos||- Community-call plans||- Quality improvement|
|- Response time||- Prospective payment system||- No-coverage periods|
|- Follow-up care||- Beneficiary & family care||- OIG proposed changes|
|- Certificate to transfer||- Poor practice examples||- Standard of care|
|- Physician education||- CMS deficiency memo|