As the high cost of healthcare has become a hotbed of issues in Denver, Colorado, and around the nation, the Federal Emergency Medical Treatment Active Labor Act—which requires hospitals to provide basic emergency treatment to nearly anyone, regardless of their ability to pay—has come under scrutiny.
However, few people outside of the medical field are familiar with what EMTALA does and does not cover. In addition, many providers are unsure what their obligations are. To understand the impact of EMTALA on the Denver/Boulder, CO medical community, it is important to understand some of the basic principles involved.
Where does EMTALA apply?
- Nearly every hospital in the State of Colorado is affected by EMTALA and therefore must provide basic screenings and stabilizing treatment for walk-in patients regardless of their ability to pay.
- This is because the the law requires them to comply with the act if they are going to participate in government programs like Medicare. Government payor programs and other government funding is a significant source of revenue and funding for hospitals so very few can “opt out” of participation in EMTALA.
What level of care is required by EMTALA?
- Essentially, any patient who enters the emergency room of a hospital and requests an examination for a medical condition must be provided with a screening exam to determine whether or not he or she has an emergency medical condition.
- If there is an emergency condition, the hospital must either stabilize the patient, or if they are unable to provide care, transport him or her to another hospital.
- If there is not an emergency condition, the doctor’s and hospital’s obligation to the patient ends. The distinction of stabilizing care is very important. In most cases EMTALA does not require medical doctors to perform surgery or to treat non-emergency issues.
What is an emergency medical condition for the purpose of EMTALA? The statute defines “emergency medical condition” as:
“A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the health of the individual (or, with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of any bodily organ or part, or with respect to a pregnant woman who is having contractions, that there is inadequate time to effect a safe transfer to another hospital before delivery, or that the transfer may pose a threat to the health or safety of the woman or her unborn child.”
How do EMTALA obligations extend to individual physicians?
When a physician is on staff or the on-call doctor at a hospital, he or she must respond to an emergency situation regardless of the patient’s ability to pay. There is nothing in EMTALA requiring a physician to accept rotation as an on-call physician. However, most hospitals require physicians who are on the medical staff or have privileges at the institution to be part of the on-call rotation.
How does EMTALA affect private physicians?
EMTALA does not generally pertain to private physicians and practices, but some institutions will impose certain “EMTALA like” conditions on private physicians as a condition of obtaining privileges or being on the medical staff. Some hospitals will require these physicians to provide emergency screening exams and stabilizing care for patients who present at the emergency room and are then are referred to these private physicians. This is an issue that many physicians may not even be aware of. Therefore, it is often best to review Medical Staff Rules and Bylaws before the hospital sends a patient to the physician’s office.
If you are a doctor, physician’s assistant, or hospital administrator who has concerns about the Federal Emergency Medical Treatment and Active Labor Act, contact a professional Colorado healthcare attorney for further guidance.
The information above is not intended as legal advice. It is merely a summary of the law and should not be relied upon as an answer to any specific legal question. If you have a specific legal question, you should seek the advice of a knowledgable and experienced healthcare attorney and may contact the Law Office of Philip M. Bluestein via e-mail or phone (303-880-4998)