Group Forums >> EMS >> EMTALA...What is it?
EMTALA...What is it?
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Posted 2 months ago What is EMTALA? The Emergency Medical Treatment and Active Labor Act is a statute which governs when and how a patient may be (1) refused treatment or (2) transferred from one hospital to another when he is in an unstable medical condition.
EMTALA was passed as part of the Consolidated Omnibus Budget Reconciliation Act of 1986, and it is sometimes referred to as "the COBRA law". In fact, a number of different laws come under that general name. Another very familiar provision, also referred to under the COBRA name, is the statute governing continuation of medical insurance benefits after termination of employment.
Reportedly, a 1989 amendment to the statute removed the word "active" from the official name of the statute. The amendment, however, cannot be found in the report of the official public law.
EMTALA is also known as Section 1867(a) of the Social Security Act. It is included as part of the section of the U.S. Code which governs Medicare.
EMTALA applies only to "participating hospitals" -- i.e., to hospitals which have entered into "provider agreements" under which they will accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program for services provided to beneficiaries of that program. In practical terms, this means that it applies to virtually all hospitals in the U.S., with the exception of the Shriners' Hospital for Crippled Children and many military hospitals. Its provisions apply to all patients, and not just to Medicare patients. (See Section 15 below.)
The avowed purpose of the statute is to prevent hospitals from rejecting patients, refusing to treat them, or transferring them to "charity hospitals" or "county hospitals" because they are unable to pay or are covered under the Medicare or Medicaid programs. This purpose, however, does not limit the coverage of its provisions -- see Sections 15 and 16 below.
EMTALA is primarily but not exclusively a non-discrimination statute. One would cover most of its purpose and effect by characterizing it as providing that no patient who presents with an emergency medical condition and who is unable to pay may be treated differently than patients who are covered by health insurance. That is not the entire scope of EMTALA, however; it imposes affirmative obligations which go beyond non-discrimination. See Section 16 below.
Taken from http://www.emtala.com/faq.htm
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| Posted 2 months ago So why do we need EMTALA? Read this article and ask yourself if this doctor violated EMTALA and if the Medics did the right thing. Fired ER Physician Sues Evac Paramedics
DAYTONA BEACH, Fla. -- A former emergency-room doctor at Bert Fish Medical Center is suing EVAC ambulance for damages he says he suffered -- including losing his job -- when paramedics in 2006 transferred a near-drowning victim to another hospital. Dr. John Milton Jr. claims in the two-page lawsuit filed in Circuit Court that he lost his job at the New Smyrna Beach hospital as a result of what he calls a breach of duty to him by EVAC paramedics. The suit claims the child was moved without his knowledge, consent or permission. The lawsuit stems from an incident on May 16, 2006, when 8-year- old Jarius Radcliff was taken by EVAC ambulance to Bert Fish after nearly drowning in a pool at a friend's house on Yule Tree Drive. At the time, Milton, then an attending ER physician at Bert Fish, said he conducted a visual evaluation on the child and determined he was stable and breathing on his own and that his circulation was OK. But the child needed more care than his facility could provide, Milton said. He said he was on the telephone trying to arrange a transfer to Halifax Health Medical Center in Daytona Beach when the ambulance crew left with Jarius. EVAC paramedics disputed Milton's account, saying they were not permitted to take the child off the stretcher, and that the doctor never evaluated or treated Jarius in the crucial 13 minutes they were there with him. While EVAC typically does not comment on pending litigation," EVAC spokesman Mark O'Keefe said, "the paramedic very wisely realized the patient needed to be transported as quickly as possible to the next closest emergency room for treatment." In a statement released a day after the incident, hospital officials said Milton, 51, violated hospital procedures and federal law requiring hospitals to treat any patient that comes through the doors of their emergency room and was terminated as a result. The incident in our emergency room on Thursday was unfortunate and should not have happened," Chief Executive Officer Bob Williams said in the statement. "The physician involved no longer works in our hospital." Miltondid not return a call seeking comment Monday. The suit seeks an unspecified amount for "severe financial consequences" that Milton suffered. According to court records, Milton is named as a defendant in two unrelated pending lawsuits. One of those suits seeks damages for a premature baby born in 2003 after Milton tried to transfer her mother to another hospital. The other lawsuit, filed last year, claims Milton failed to provide adequate emergency medical management to a man who died after he went to Bert Fish in December 2005 with difficulty breathing. Jarius was released from Halifax Health about a week after he was taken there for treatment. |
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| Posted 2 months ago I feel that the medics did the complete right thing. And that the doctor was in the wrong, whether or not he evaluated the pt or not. Patient care is top priority, and that is exactly what the medics had in mind whenever they transported the kid. There is no reason that the doctor shoud be able to sue the EVAC ambulance company. |
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| Posted 2 months ago I agree. The doc blew it, and needs to own up to it. |
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| Posted 2 months ago Yes he needs to own up on it. But everyone knows that he won't, and that the ambulance service will get the main brunt of it because the doc has more certification and theoretically more knowledge. But in this case the medic was completely in the right, and should not be held responsible for decisions that saved a patient. with or without the law. |
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| Posted 2 months ago Agree 100%. The doc blew this one.........and it's a shame! Kudo's to the medics who had the perverbial "gonads" to do what was right for the patient. Ross Caston
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| Posted 2 months ago I agree the doc's in the wrong. I would like hear the medics account of it all. |
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| Posted 24 days ago Morally/ethically the medics are in the right... legally... not so sure. They stepped through the doors of that ER... thier transport is complete. Had they not been able to get in the ER bay due to some catastrophic explosion blocking the entrance after they arrived which caused them to then head out of that parking lot and off to the next closest hospital they would have never been sued. Fact of the matter is... hospital property... hospital rules. If the kid died while waiting for Dr. Stupid to finally get over and do an assessment... it is not your fault. You just keep him on your monitor and keep him breathing till then. If the kid had started to crash while waiting on your stretcher maybe the doc would have had a little more pep in his step to do his assessment. The doc is in the wrong, of course, but the medics should not have left the ER once they arrived. I once had a doc who didn't want me to take the patient off the strectcher.... Fall victim over 90yrs old. He came over cleared her c-spine and asked us to take her back to the nursing home we got her from. I waited until the nurse walked away... and we move our patient over to the nearest hospital cot. Told the nurse to call us when the patient had paperwork completed showing her admittance, diagnosis, and discharge. This did not make my company, the nurse, or doc happy but I knew I wouldnt be the one getting sued when it came back she had a c-spine fracture or concussion or bleed or worse. (as an aside... she was transported back to the nursing home a few hours later... but a crew from our station picked her up 4 days later comatose... she did have a bleed, went undiagnosed b/c the doc didnt want to do the CT, and she slowly became more lethargic... nursing home not really noticing till the family visited later that week... I was glad I did what I did... no lawsuit pending that I know of... at least not on my end) Cover your ass. Thats what its about. Wish the patient well. Know you did what YOU were supposed to do... and put faith in the system that dumbass docs like him get caught when they F*** up so they get fired and you don't. |