Emergency Medical Treatment and Active Labor Act
26 EMS Professional  September 2009 Issue Focus Main Points Emergency physicians are proud to serve as an essential part of the nation's health care safety net, open 24/7, caring for everyone, regardless of ability to pay or insurance status. EMTALA is an unfunded mandate that does not require health insurance compa-nies, governments or individuals to pay for mandated services. The growing problem of uncompen-sated care is closing many emergency de-partments, decreasing resources for everyone and threatening the ability of emergency departments to care for all pa-tients emergency physicians of all med-ical specialists provide the most charity care (AMA 2003). ACEP advocates for recognition of un-Emergency Medical Treatment and Active Labor Act compensated care as a legitimate practice expense for emergency physicians and for federal guidance in how fulfill the re-quirements of the EMTALA mandate in light of its significant burden on the na-tion's emergency care system. Q. What is EMTALA? A. EMTALA was enacted by Congress in 1986 as part of the Consolidated Om-nibus Budget Reconciliation Act (CO-BRA) of 1985 (42 U.S.C. §1395dd). Its original intent and goals are consistent with the mission of ACEP and the public trust held by emergency physicians. Referred to as the anti-dumping law, it was designed to prevent hospitals from transferring uninsured or Medicaid pa-tients to public hospitals without, at a minimum, providing a medical screening examination to ensure they were stable for transfer. As a result, local and state governments began to abdicate responsi-bility for charity care, shifting this pub-lic responsibility to all hospitals. EMTALA became the de facto national health care policy for the uninsured. Con-gress in 2000 made EMTALA enforce-ment a priority, with penalties more than $1.17 million, nearly as much as in the first 10 years (about $1.8 million) of the statute combined (U.S. Department of Health and Human Services' Office of In-spector General [OIG]). Between Octo-ber 1, 2005, and March 31, 2006, $345,000 in fines were collected from 12 hospitals and one physician. By American College of Emergency Physicians Photo: Wilbur Scales EMS_0909_p26-28:Layout 1 9/4/09 3:38 PM Page 26