ClinicalEMTALA: The Evolution of Emergency Care in the United States
Section snippets
Old Practices in Emergency Care
A patient presents to the emergency department at a local hospital with a complaint of chest pain. The initial evaluation of the patient in the triage area includes registration of the patient and certification of insurance coverage. The patient is discovered to be insured by a policy from a health care insurance carrier that does not have a contract with the hospital. The patient, who is still having chest pain, is told to go to a hospital that accepts that patient's insurance for payments and
The Advent of EMTALA
In response to this bad behavior on the part of medical facilities and negative patient outcomes that resulted from it, Congress acted in 1986, with the inclusion of the EMTALA as part of the Consolidated Omnibus Budget Reconciliation Act of 1986.2 This Act included legislation addressing companies providing continuing access to health insurance coverage when employees no longer qualified for their employer-sponsored plan for reasons including leaving employment, becoming Medicare eligible, and
What the Law Requires
As drafted by Congress, EMTALA is written as a highly detailed statute, with provisions in place in its 10 subsections that clearly spell out the obligation for facilities and providers who receive Medicare reimbursement, with regard to patient emergency care.2 Specifically, for any hospital that falls under the requirement, any patient who presents with a suspected emergent condition requesting care, providers must perform a screening evaluation and provide treatment to stabilize any
Effects of EMTALA on Emergency Care
Since the passage of EMTALA and the implementation of the statutes that ensure that people have prompt access to emergency health care, the new law has clearly affected emergency departments in the United States. Although, overall, the argument would often be made that the Act has had a positive impact on access and equality with regard to care, there are other factors to consider.
Conclusion
Enacted in 1986, the emphasis of EMTALA is to prevent hospitals from refusing to provide medical care to patients for financial reasons.8 The law provides for an obligation of duty to patients who present for emergency care, regardless of their ability to pay for services rendered for that care.2 In the decades since its passage and subsequent implementation, the law has acted as safeguard for persons in the United States against economic discrimination and has undoubtedly saved many patients
Heather L. Brown is Assistant Adjunct Professor, Department of Physician Assistant Studies, College of Health Professions, Mercer University, Atlanta, GA.
References (8)
Why patients still need EMTALA; 2016
The enduring role of the Emergency Medical Treatment and Active Labor Act
Health Affairs
(2013)- et al.
Health Law
(2015) - et al.
Complying with the Emergency Medical Treatment and Labor Act (EMTALA): challenges and solutions
J Healthc Risk Manag
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Cited by (8)
The Emergency Nurses Association: 50 Years of Advocacy and Advancement
2021, Journal of Emergency NursingEmergency Care EMTALA Alterations During the COVID-19 Pandemic in the United States
2021, Journal of Emergency NursingCitation Excerpt :In addition, the use of the term “duty to treat” became irrevocably tied to ED care in the US, whereas earlier there existed wide latitude afforded to providers in choosing who to see and who not to. In EMTALA, a clear exception to the “no-duty principle” was established for cases of emergency medical care, mandating that a duty to treat a patient does exist for emergency health care providers and facilities for all patients who present for care, regardless of prior relationship or ability to pay for services.4 The so-called “dumping” of patients based on their demographics or insurance has become a practice of the past, and health care entities and providers face stiff penalties if care is refused to anyone who meets the criteria under EMTALA.5
Access to Healthcare Services among Thai Immigrants in Japan: A Study of the Areas Surrounding Tokyo
2023, International Journal of Environmental Research and Public HealthThe Implications of the Emergency Medical Treatment and Labor Act and the No Surprises Act for Plastic and Reconstructive Surgeons
2023, Plastic and Reconstructive SurgeryCharacteristics of Vulnerable Foreigners in Need of Emergency Care Support in Japan: A Case Study of Thai Nationals from 2004 to 2020
2023, Journal of Immigrant and Minority HealthUsing Occupational Histories to Assess Heat Exposure in Undocumented Workers Receiving Emergent Renal Dialysis in Georgia
2022, Workplace Health and Safety
Heather L. Brown is Assistant Adjunct Professor, Department of Physician Assistant Studies, College of Health Professions, Mercer University, Atlanta, GA.
Thomas B. Brown is Nurse Navigator, Structural Heart and Valve Program, Emory University, Atlanta, GA.
Earn Up to 7.5 Hours. See page 467.