Emtala

[VA Hopeful Dr]

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Hey folks,

Some of us over in Everyone were discussing a new ED that someone found and the question of EMTALA came up. I figured you folks would be the best suited to offer non-binding opinions on the subject.

Assuming a hospital takes no government reimbursements (Medicare, Medicaid, Tricare), is the ED there required to abide by EMTALA? I guess more generally, would such an ED be required to treat absolutely everything that walked in the door, no exceptions?

 

[docB]

No and no.

In theory a "facility" that does not participate in any government programs is not bound by EMTALA and therefore has no legal obligation to treat everyone who presents to their door without regard to ability to pay.

Some good info here:
http://www.emtala.com/faq.htm
You can also do a search on SDN and especially on the EM forum to get lots of opinion (including various rants on the subject by your truly).

EMTALA applies only to "participating hospitals" -- i.e., to hospitals which have entered into "provider agreements" under which they will accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program for services provided to beneficiaries of that program. In practical terms, this means that it applies to virtually all hospitals in the U.S., with the exception of the Shriners' Hospital for Crippled Children and many military hospitals. Its provisions apply to all patients, and not just to Medicare patients. (See Section 15 below.)

I say "in theory" because practically every ED in the US participates in CMS. If you have found one that does not and is therefore not bound by EMTALA then that's newsworthy.

 

[W222]

DocB I was reading the EMTALA stuff and aren't ED's required, regardless of medicare status, to at the very least stabilize and transfer? After reading the EMTALA act it appears that anyone who publicly advertises ER services, is licensed as an ER, and/or has 1/3 of its visits as ER cases is bound to atleast examine and stabilize any patient that shows up in the ER. This is because if you advertise as an ER, a reasonable person can expect treatment for an emergency if they show up there.

I know there are some issues with having on-call staff to provide additional services, but that is a seperate issue.

 

[VA Hopeful Dr]

No and no.

In theory a "facility" that does not participate in any government programs is not bound by EMTALA and therefore has no legal obligation to treat everyone who presents to their door without regard to ability to pay.

Some good info here:
http://www.emtala.com/faq.htm
You can also do a search on SDN and especially on the EM forum to get lots of opinion (including various rants on the subject by your truly).



I say "in theory" because practically every ED in the US participates in CMS. If you have found one that does not and is therefore not bound by EMTALA then that's newsworthy.

Much obliged, and I've definitely followed some of those threads/rants.

Here's the site that got us talking...

http://www.firstchoiceer.com/services.htm

First Choice Emergency Room provides a full range of emergency medical services for both the adult and pediatric patient. We file with all insurance carriers with the exception of Medicare, Medicaid and TriCare. No appointment is needed.