Understanding Patient Rights with Emergency Medical Care
Patient Question: Recently I’ve read stories about hospitals turning away patients that don’t have health insurance or a way to pay their hospital bills. Can a hospital turn away patients in an Emergency?
The Emergency Medical Treatment and Labor Act (EMTALA) is a law that is designed to ensure that individuals who seek emergency medical attention at hospitals are not turned away or transferred based on their ability to pay.
In an emergency medical situation, it’s critical for patients to understand their rights with EMTALA, the Emergency Medical Treatment and Labor Act.
What is EMTALA?
EMTALA stands for the Emergency Medical Treatment and Labor Act. It is a federal law in the United States that was enacted in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). EMTALA is designed to ensure that individuals who seek emergency medical care at hospitals are not turned away or transferred based on their ability to pay or their insurance status. EMTALA is crucial for ensuring that people in need of emergency medical care receive prompt and appropriate treatment, regardless of their financial situation. It plays a vital role in safeguarding the rights of patients seeking emergency care and preventing situations where individuals are denied treatment or transferred improperly.
The primary purposes of EMTALA are to:
Provide Emergency Care: EMTALA requires hospitals that participate in Medicare (virtually all hospitals in the U.S.) to provide an appropriate medical screening examination and stabilizing treatment to anyone who comes to the emergency department (ED) seeking care for a medical condition, regardless of their ability to pay, insurance status, or citizenship.
Prevent Patient Dumping: The law prohibits hospitals from "dumping" patients – that is, refusing to treat or transferring patients to another facility without conducting a proper medical assessment and, if necessary, providing necessary treatment to stabilize their condition.
Define EMTALA Applicability: EMTALA applies when an individual presents to a hospital's dedicated emergency department (ED) or to a hospital campus for treatment of an emergency medical condition. It also applies to transfers between hospitals.
Stabilization of Emergent Conditions: If a patient has an emergency medical condition, EMTALA requires the hospital to provide treatment to stabilize that condition. This may include stabilizing surgeries, interventions, or necessary medical care until the patient is no longer at risk of severe deterioration.
Penalties for Non-Compliance: Hospitals that violate EMTALA can face significant penalties, including fines, and may be excluded from the Medicare program, which can have severe financial consequences for a hospital.
All patients have the right to Emergency Medical Care in the US and there are important steps you should take if EMTALA is not being followed.
What if your ER visit does not follow EMTALA rules, what can you do?
It's essential to advocate for your own well-being and rights when seeking medical care in an emergency situation. EMTALA exists to ensure that patients receive appropriate care, and reporting violations is an important step in upholding these regulations and protecting patient rights.
If you believe that the Emergency Medical Treatment and Labor Act (EMTALA) is not being followed correctly during an ER visit, you should take the following steps:
Notify Hospital Staff: The first and most immediate action should be to notify the hospital staff of your concerns. Speak to the triage nurse, the attending physician, or the charge nurse and express your belief that EMTALA regulations are not being followed. Provide specific details about why you believe this is the case.
Request a Patient Advocate: Many hospitals have patient advocates or patient liaison programs in place. Request to speak to a patient advocate or liaison who can help address your concerns and advocate on your behalf.
Document the Situation: Make detailed notes about the situation, including names, dates, times, and any relevant conversations or interactions with hospital staff. This documentation can be crucial if you need to file a complaint or escalate the issue later.
Consider Requesting a Transfer: If you believe your condition warrants it and you are not receiving appropriate care, you may request a transfer to another facility that can provide the necessary care. EMTALA requires that hospitals stabilize emergency medical conditions before transfer, so make sure you communicate your concerns about your medical condition.
Contact Hospital Administration: If your concerns are not addressed at the ER level, you can contact the hospital's administration or patient relations department to file a formal complaint. They may be able to investigate the situation and take appropriate action.
Contact Local Authorities: In cases where you believe EMTALA violations are severe and immediate corrective action is not being taken, you can contact your state's health department or regulatory agency responsible for overseeing healthcare facilities. They can investigate and take regulatory actions if necessary.
Contact CMS: The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for enforcing EMTALA. You can contact CMS to report violations directly. They can investigate and take action against hospitals that fail to comply with EMTALA regulations.
Seek Legal Advice: If you believe that EMTALA violations have resulted in harm or neglect and your concerns have not been adequately addressed through other channels, you may want to consult an attorney who specializes in healthcare law. They can provide guidance on potential legal actions.
