Legal Issues - EMTALA

Legal Issues - EMTALA

Introduction

In a scenario when I, as an administrator for a local hospital, received a call at 2:00am from another local hospital regarding a patient with a broken upper arm. The ED physician's assistant is calling to arrange an EMTALA transfer from his hospital to my hospital, but the orthopedic physician on call at my hospital is refusing to accept the transfer, stating that the patient does not need a higher level of care. When I asked him about that, he told me the fracture is not displaced, and can be splinted and seen in the office. As an administrator, I would guide him through the situation under the provision of EMTALA, as it can also fall under the violation of EMTALA.

Discussion

Emergency Medical Treatment and Labor Act (EMTALA)

The mentioned scenario is referred to the EMTALA. It is a law for the patient antidumping that was approved in 1986. It was a part of Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, Public Law 99-272 (Medscape, 2012). Congress has integrated such rules of antidumping patient in Social Security Act that made sure the conditions where medical emergency has occurred cannot be denied by life saving services. The individual who request treatment or examination for medical condition will be required examinations for medical screening under the Act of section 1987.

The further explanation to this section provides the provision to hospitals or medical service providers that they are obligated to provide all the necessary treatment to stabilize the condition of the individual in a medical situation of emergency. Medical service providers are also obligated to transfer the patient to another hospital to stabilize the condition of the patient if it is appropriate and necessary. Under the law of EMTALA, hospital is obligated to accept the appropriate transference of the individual from other hospital. It is stated under the Act of Section 1867 (g) that hospitals that have capabilities and specialized facilities, such as care units of neonatal intensive, shock-trauma units, burn units etc. will not decline the appropriate transference of patient who needs such capabilities or specialized facilities if the hospital can provide such special services for the treatment of an individual.

EMTALA Technical Advisory Group (TAG)

The formation of EMTALA TAG is to provide advises on issues related to EMTALA to Secretary and ensure its implementation. The other functions of EMTALA TAG are to review and assess the regulations of EMTALA; ask for recommendations and comments from public, physicians, and hospitals related to the application of stated regulations; and distribute information related to the implementation of regulations to public, physicians, and hospitals. EMTALA TAG has presented few recommendations to Secretary (Centers for Medicare & Medicaid Service, 2013). One of the aforementioned proposals calls for CMS to reexamine its regulations to address the scenario of a person who:

Presents to a medical service provider that has a committed section for emergency and is resolved to have an unstabilized emergency medical condition;

is acceded the medical service provider as ...