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New EMTALA Regulations
The Emergency Medical Treatment and Labor Act (EMTALA), which imposes requirements on hospitals with emergency departments to screen and stabilize anyone who comes to the emergency department seeking treatment, can provide the basis for a private civil action against the hospital if a person is injured by the hospital's violation of its requirements. See 42 U.S.C. ' 1395dd. New regulations clarifying hospitals' obligations under EMTALA went into effect November 10, providing new guidance on how the federal agency charged with enforcing the statute interprets its terms. See 68 Fed. Reg. 53222 (9/9/03), amending 42 C.F.R. '' 489.24, 413.65(g), and 482.12. (The newly defined terms discussed in this article are all in ' 489.24(b).)
Enacted in 1985 as Pub.L. 99-272, ' 9121, EMTALA was Congress' answer to a perceived problem of some hospital emergency departments' transferring medically unstable individuals to other facilities, either because the patients were indigent or because what health care coverage they had was limited to other hospitals. The statute requires hospitals that participate in Medicare and have an emergency department to medically screen anyone who “comes to the emergency department” seeking treatment for a medical condition to determine whether an “emergency medical condition” exists. If it does, the hospital must either stabilize the patient's condition or arrange for a transfer; however, the hospital may only transfer the patient if the medical benefits of the transfer outweigh the risks, or if the patient requests the transfer.
EMTALA is enforced by the Centers for Medicare & Medicaid Services (CMS) of the Department of Health and Human Services (HHS), which may invoke a number of penalties for violations by hospitals or physicians. In addition, a person who suffers personal harm as a direct result of a hospital's (but not a physician's) EMTALA violation may bring a civil action for damages and/or equitable relief against the hospital. 42 U.S.C. ' 1395dd(d)(2).
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