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Topic: Emergency Medical Treatment and Active Labor Act

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	Office of Legal Affairs -- Emergency Medical Treatment & Active Labor Act (Site not responding. Last check: 2007-10-14)
		The Emergency Medical Treatment and Active Labor Act ("EMTALA") is a federal law which requires hospitals that receive Medicare funds to treat individuals who come to the hospital with an emergency medical condition regardless of their ability to pay.
		If the hospital is capable of providing the necessary emergency care to a patient and an emergency medical condition is found to exist, the hospital is prohibited from refusing to provide any treatment to the individual or from transferring the patient to another medical facility without good cause.
		Thus, an appropriate medical screening must be provided to every person who comes to an emergency treatment center in order to determine whether an emergency medical condition exists or, in the case of a pregnant woman, whether labor is imminent.
	www.uphs.upenn.edu /legal/emt.html (462 words)

	ACUTE CARE, INC. - Emergency Physicians - Practice Opportunities, Information (Site not responding. Last check: 2007-10-14)
		If the individual has come to the hospital and the hospital has determined that he or she is in an emergency medical condition, the hospital must provide further medical examination and treatment to stabilize the medical condition.
		The Emergency Medical Treatment and Active Labor Act (EMTALA) establishes specific responsibilities for physicians attending to the Emergency Department patient.
		"Emergency Department" is actually an inexact term, in that the provisions of the law apply to patients who present, on hospital property, for purposes of examination and treatment of medical complaint.
	www.acutecare.com /emtala.htm (1158 words)

	Louisiana medical review panel requirement preempted by EMTALA - Spradlin v. Acadia-St. Landry Medical Foundation, 758 ...
		However, as defendant concedes, the period of time a medical review panel takes to render a decision is outside of the malpractice victim's control, and extensions of the time for the panel decision are common so that the timing of the decision frequently occurs outside the two-year period for filing an EMTALA claim.
		The statement by the court of appeal that EMTALA claims are not subject to the procedural and substantive limitations of the state malpractice act was dicta, since substantive limitations were not before the court.
		Whether there was any negligence in the diagnosis and treatment by the emergency room doctor prior to the decision to transfer is a matter to be addressed in the separate medical malpractice action.
	biotech.law.lsu.edu /cases/EMTALA/Spradlin.htm (3441 words)

	Consent for Emergency Medical Services for Children and Adolescents \| HHCS - March 2003 (Site not responding. Last check: 2007-10-14)
		Under U.S. common law, parental consent generally is required for the medical treatment of minor children, the statement notes, but states have enacted a number of statutes that allow for the treatment of minors without parental consent in situations that often arise in emergency departments.
		EMTALA preempts conflicting or inconsistent state laws, essentially rendering the problem of obtaining consent for the emergency treatment of minors a non-issue for participating hospitals.
		Appropriate medical care for the pediatric patient with an urgent or emergent condition should never be withheld or delayed because of problems with obtaining consent.
	www.healthinschools.org /ejournal/2003/mar03_2.htm (453 words)

	Chapter 13 EMERGENCY TRANSFER LAWS
		An appropriate medical screening examination must be provided to each person who presents at an emergency department to determine whether or not the person does in fact have a medical emergency or is in active labor.
		In cases where the labor is considered to be an emergency medical condition, the physician must either "stabilize" the woman or transfer her to another appropriate facility.
		With respect to an emergency medical condition, "to stabilize" means to provide such medical treatment of the condition that is necessary to assure, within reasonable medical probability, that no material deterioration of the condition is likely to result from or occur during the transfer of the individual from a facility.
	www.lvcm.com /whavins/nplh13.htm (6588 words)

	Emergency Patients
		For purposes of EMTALA, a hospital is deemed to have met the requirement of providing examination and treatment if the hospital offers examination and treatment and informs the individual (or a person acting on the individual's behalf) of the risks and benefits to the individual of such examination and treatment.
		Where the individual refuses treatment, hospital personnel shall take all reasonable steps to secure written informed consent of the individual's refusal to accept examination and/or treatment.The laws in Texas pertaining to consent to medical treatment are found within the Texas Health and Safety Code and also within certain portions of the Texas Family Code.
		The act also contains some other definitions of importance, such as "decision-making capacity", which means an ability to understand and appreciate the nature and consequences of a decision regarding medical treatment and the ability to reach an informed decision.
	www.houstonlaw.com /htmlversion/article2.htm (1431 words)

	Emergency Care: EMTALA Implementation and Enforcement Issues (Site not responding. Last check: 2007-10-14)
		The form addresses such issues as whether the patient had an emergency medical condition, the patient received an appropriate medical screening exam, the patient's emergency medical condition was stabilized at the time of transfer, and the hospital provided an appropriate transfer.
		Although from 1994 to 1998, the rate of growth of emergency department visits nationwide barely exceeded the rate of population growth, the number of emergency departments declined by 8 percent from 1994 to 1999, so the end result could be increased volume in certain hospitals.
		All off- site departments are required to have protocols that provide for direct contact between their staff and emergency staff at the main hospital, and off- site department staff may not routinely respond to all emergencies by calling 911 and always relying on the emergency medical system to assume responsibility for the patient.
	www.washingtonwatchdog.org /documents/gao/01/GAO-01-747.html (10805 words)

	eMedicine - COBRA Laws : Article Excerpt by: Jerome FX Naradzay, MD, FACEP (Site not responding. Last check: 2007-10-14)
		Emergency Medical Treatment and Active Labor Act (EMTALA) requires a hospital to provide an appropriate medical screening examination to any person who comes to the hospital emergency department (ED) and requests treatment or an examination for a medical condition.
		The initial intent of EMTALA was to address the alleged practices of some hospitals transferring, discharging, or refusing to treat patients who did not have insurance.
		In the EMTALA statute, obligations are tied to hospitals' participation in Medicare.
	www.emedicine.com /emerg/byname/cobra-laws.htm (629 words)

	Alleged Anti-Dumping Violations and EMTALA (Emergency Medical Treatment and Active Labor Act)
		Hospitals with emergency departments (ED) and/or specialty units are prohibited by the Omnibus Budget Reconciliation Act (OBRA) from turning away or transferring patients without screening for emergency medical conditions and stabilizing such conditions or determining that a transfer is in the best interest of the patient.
		EMTALA requires participating hospitals with EDs to provide an appropriate medical screening examination within the capacity of the hospital's ED, including ancillary services routinely available to the ED.
		Unless the individual or a person acting on the individual's behalf refuses treatment or transfer after being advised by the hospital of the risks and benefits involved, the hospital must provide to an individual who is determined to have an emergency medical condition either:
	www.nmmra.org /providers/review_antidump.php (394 words)

	Emergency Medical Treatment and Active Labor Act "EMTALA"
		EMTALA is intended to address the failure of a hospital to recognize an emergency condition due to inadequate screening procedures, and, if an emergency condition exists, the failure to properly stabilize, transfer or treat the patient in accordance with the hospital's capabilities.
		EMTALA prohibits the hospital from taking any adverse action against or penalizing any qualified medical person or physician because they refuse to authorize the transfer of an individual with an emergency medical condition that has not been stabilized.
		EMTALA is not intended to require a hospital owned and operated ambulance to transport a patient to the owner hospital despite the patient's request to be transported to a different hospital.
	library.findlaw.com /2001/Jan/1/126650.html (2041 words)

	Emergency Medical Treatment and Active Labor Act (EMTALA): Triage Nurse's Assessment
		The EMTALA requirement of an appropriate screening examination in the emergency room means that hospitals must determine what their screening requirements will be, and then apply them uniformly to all individuals who come into the emergency room.
		It was not the hospital’s actual practice for its policy regarding vital signs to be interpreted by emergency room nurses to require blood pressures be taken on all pediatric patients at the time of initial triage in the emergency room.
		The key to the EMTALA is the hospital’s policies and practices for E.R. patients with specific presenting complaints, and whether the hospital has screened, examined and treated the patient in question in the E.R. in line with its own policies and standard practices, according to the court.
	www.nursinglaw.com /emtala.htm (706 words)

	Overview
		Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay.
		Emergency Medical Treatment and Labor Act Technical Advisory Group (EMTALA TAG)
		{EMTALA provisions are in paragraphs (I) (i), (ii), and (iii) and (N)(iii)}
	www.cms.hhs.gov /EMTALA (239 words)

	AMA Statement to the EMTALA Technical Advisory Group (Site not responding. Last check: 2007-10-14)
		It clarifies that EMTALA is intended to apply to emergency department admissions rather than to patients who have been admitted to the hospital as inpatients and later develop emergency conditions.
		A hospital off-campus facility that does not meet the definition of a dedicated emergency department does not have an EMTALA obligation and is not required to be staffed to handle potential emergency medical conditions.
		Emergency departments have become this country’s health care for the uninsured and it is extremely difficult for either hospitals or physicians to finance this growing level of uncompensated care.
	www.ama-assn.org /ama/pub/category/print/14950.html (2369 words)

	EMTALA (Anti-Dumping) Resources
		EMTALA requires a hospital to provide an appropriate medical screening examination to any person who comes to the hospital emergency department and requests treatment or an examination for a medical condition.
		EMTALA 250 yard regulation-Based upon the Ravenswood Hospital case, this regulation requires hospitals to be capable of responding directly (not just EMS) to patients requiring assistance who present within 250 yards of the hospital building.
		Blood Alcohols, Labs and Minor Treatments in the ED- The ER is often used by police to draw blood alcohol levels on allegedly intoxicated drivers, physicians obtain lab tests or x-rays during off-hours, and hospitals provide urine drug screens on injured workers, prescription refills, allergy shots, rabies vaccinations or blood transfusions.
	medi-smart.com /cobra.htm (1176 words)

	eMedicine - Federal Law and Emergency Medicine : Article by Robert Derlet, MD (Site not responding. Last check: 2007-10-14)
		Stabilization means, with respect to an emergency medical condition as defined, “that no material deterioration of the condition is likely within reasonable medical probability to result from or occur during the transfer of the patient from a facility” (or discharge).
		A patient's medical condition has the potential to worsen en route, yet no clear legal consensus exists on lateral or downward transfers that are purely for financial reasons.
		The emergency physician, nursing staff, and appropriate hospital administrators must be familiar with this body of law and understand its implications.
	www.emedicine.com /emerg/topic860.htm (2547 words)

	The California Patient's Guide: IV - Your Right to Emergency Medical Care
		Any pregnant woman who is having contractions has an emergency medical condition if there is inadequate time before delivery of the baby to have her safely transferred to another hospital, or if such a transfer may pose a threat to the health or safety of the woman or unborn child.
		When you go to a hospital's emergency department, you must be examined by a doctor, or other appropriate personnel under the doctor's supervision, in order to determine whether you have an "emergency medical condition," or are in "active labor," in a pregnant woman's case as discussed above.
		Emergency services must also be supervised by qualified members of the medical staff, and there must be adequate medical and nursing staff who are qualified in emergency care to carry out written emergency procedures and meet the needs anticipated by the hospital.
	www.calpatientguide.org /iv.html (1534 words)

	ACP-ASIM Observer, November 2001 - Emergency access is mandated-but without money
		Federal legislators passed the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986 in the wake of the newly implemented diagnosis related groups (DRG) reimbursement system.
		The act also requires hospital bylaws to define the responsibilities of on-call physicians and implement policies to guide emergency workers when a specialist is not available or when an on-call physician is not able to respond.
		Physicians providing emergency care—including those on call—who violate any part of the law are subject to a $50,000 fine and can be excluded from Medicare.
	www.acponline.org /journals/news/nov01/mandate.htm (759 words)

	EMTALA (Site not responding. Last check: 2007-10-14)
		The Emergency Medical Treatment and Active Labor Act of 1986, amended in 1989, was enacted by Congress to guard against patient dumping in hospital emergency rooms.
		The law and its corresponding regulations is called by different names, most particularly EMTALA, COBRA (because its provisions were part of the major 1986 Consolidated Omnibus Budget Reconciliation Act of 1986), or PADS (referencing patient dumping).
		EMTALA regulations are found at 42 CFR 489.24 (Code of Federal Regulations).
	www.iowamedical.org /ola/emtala.htm (157 words)

	EMTALA Signage Requirements
		This memo summarizes the requirement under the federal Emergency Medical Treatment and Active Labor Act (EMTALA) for hospitals to post signs in the emergency department as well as certain off-campus and outpatient departments.
		The sign(s) must be posted in a place or places likely to be noticed by all individuals entering the emergency department, as well as those individuals waiting for examination and treatment (e.g., entrance, admitting area, waiting room, treatment area).
		Any off-campus department where patients may wait for examination or treatment for an emergency medical condition must adhere to the minimal signage requirements at the hospital according to the regulations at 42 CFR § 489.20 (q).
	www.ihatoday.org /issues/legal/emtala.html (693 words)

	The Emergency Medical Treatment and Active Labor Act of 1985 and the Practice of Psychiatry -- Quinn et al. 53 (10): ...
		The Emergency Medical Treatment and Active Labor Act of 1985 and the Practice of Psychiatry -- Quinn et al.
		The Emergency Medical Treatment and Active Labor Act of 1985 and the Practice of Psychiatry
		42 USCA Sec 1395 dd The Emergency Medical Treatment and Active Labor Act (EMTALA)
	psychservices.psychiatryonline.org /cgi/content/full/53/10/1301 (4318 words)

	Emergency Medical Treatment and Active Labor Act - Wikipedia, the free encyclopedia
		The Emergency Medical Treatment and Active Labor Act (42 U.S.C. § 1395dd, EMTALA) is a United States Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act.
		It requires hospitals and ambulance services to provide care to anyone needing emergency treatment regardless of citizenship, legal status or ability to pay.
		There are no reimbursement provisions; as a result of the act, patients needing emergency treatment can be discharged only under their own informed consent or when their condition requires transfer to a hospital better equipped to administer the treatment.
	en.wikipedia.org /wiki/Emergency_Medical_Treatment_and_Active_Labor_Act (146 words)

	Social Security Act §1867
		(A) in which the transferring hospital provides the medical treatment within its capacity which minimizes the risks to the individual's health and, in the case of a woman in labor, the health of the unborn child;
		The Secretary shall provide a copy of the organization's report to the hospital or physician consistent with confidentiality requirements imposed on the organization under such part B..—The Secretary shall establish a procedure to notify hospitals and physicians when an investigation under this section is closed.
		II, P.L. with respect to an emergency medical treatment and labor act technical advisory group and §1011, with respect to the Federal reimbursement of emergency health services furnished to undocumented aliens.
	www.ssa.gov /OP_Home/ssact/title18/1867.htm (1041 words)

	EM Topics: EMTALA (Site not responding. Last check: 2007-10-14)
		The Emergency Medical Treatment and Active Labor Act (EMTALA) was included in the COBRA legislation of 1986.
		It was promulgated to combat the discriminatory practice of some hospitals transferring, discharging, or refusing to treat indigent patients coming to the emergency department because of the high cost associated with diagnosing and treating these patients with emergency medical conditions.
		A hospital must not transfer an individual with an emergency medical condition that has not been stabilized unless several conditions are met that includes effecting an appropriate transfer.
	www.aaem.org /emtala/index.shtml (413 words)

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