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1 1 (May 8, 2008)

handle is hein.crs/crsajqd0001 and id is 1 raw text is: Order Code RS22738 Updated May 8, 2008 EMTALA: Access to Emergency Medical Care Edward C. Liu Legislative Attorney American Law Division Summary The Emergency Medical Treatment and Active Labor Act (EMTALA) ensures universal access to emergency medical care at all Medicare participating hospitals with emergency departments. Under EMTALA, any person who seeks emergency medical care at a covered facility, regardless of ability to pay, immigration status, or any other characteristic, is guaranteed an appropriate screening exam and stabilization treatment before transfer or discharge. Since its enactment in 1986, the differing interpretations of the statute's requirements by various courts and the Department of Health and Human Services (HHS) have resulted in conflicts, several of which remain unresolved. Overview In 1986, Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA)l to address the problem of patient dumping in hospital emergency departments.2 Although attempts to facilitate indigent access to emergency health care already existed in state and federal law, legal frameworks prior to EMTALA were plagued with poor enforcement mechanisms and vague standards of conduct.3 Amid graphic media reports of hospitals sending away critically ill patients without proper stabilization treatment and delivery rooms unwilling to accept indigent or uninsured women in labor, Congress passed EMTALA as part of the Consolidated Omnibus Budget Reconciliation Act of 1985.4 1 P.L. 99-272, 100 Stat. 164 (1986) codified at 42 U.S.C. § 1395dd et seq. (2007). 2 Patient dumping occurs when a hospital turns away indigent or uninsured persons seeking treatment so that the hospital will not have to absorb the cost of treating them. 3 Tiana Mayere Lee, An EMTALA Primer: The Impact of Changes in the Emergency Medicine Landscape on EMTALA Compliance and Enforcement, 13 ANNALS OF HEALTH LAW 145, 146-147 (2004) (discussing the Hill-Burton Act and state statutory and common law). See also H.Rept. 99-241, pt. 3, at 5 (1985) (discussing state remedies). 4 Lee, supra note 3 at 147-148, 151. In 2003, Congress appropriated $1 billion over fiscal years 2005-2008 to reimburse hospitals for medical care provided to undocumented aliens. Two thirds (continued...)

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