ED Quality News: New EMTALA Regulations
The Centers for Medicare & Medicaid Services (CMS) issued its final rule on the Emergency Medical Treatment and Labor Act (EMTALA) on August 28, 2003. The Final Rule clarifies hospital obligations to patients who request treatment for emergency medical conditions and removes barriers to efficient emergency department operations. It became effective today.
According to CMS Administrator Tom Scully,
"the rule will improve people's access to emergency care by encouraging
physicians to be on call and by permitting hospitals to take the most
effective steps for getting emergency treatment for patients who need it."
This means that
non-emergency sites (physicians' offices, nursing homes) are now exempt from
EMTALA. Non-emergency sites were never intended to be covered under EMTALA, but
the original regulations were overbroad, necessitating this change.
This doesn't solve the
problem of a lack of physicians willing to be on-call, but does make it a little
easier for a facility to create an on-call list from available providers. The
changes do not address the fundamental issues limiting on call availability:
medical malpractice liability, declining reimbursement and uncompensated care.
This allows a
hospital-owned ambulance to transport a patient to the closest appropriate
hospital as per accepted practice.
Once the patient is admitted, the EMTALA obligation is satisfied. This should make it
harder for aggressive plaintiff attorneys to utilize EMTALA as a federal cause
for malpractice based upon poor patient outcome, rather than as a result of
financial discrimination - for which the law was intended.
8. EMTALA does not apply in a national emergency. Hospitals may transfer patients to other facilities, even such transfers would otherwise be violation of the EMTALA requirements.
"We believe this regulation will help to ensure that emergency departments
and specialty physicians are there for those who need them," Administrator
Scully said. It will "help hospitals focus less on unnecessary requirements
and more on providing quality care to their patients."
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