The Emergency Medical Treatment and Active Labor Act (EMTALA) is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.
EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals. The combined payments of Medicare and Medicaid, $602 billion in 2004, or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, and not just to Medicare patients.
The cost of emergency care required by EMTALA is not directly covered by the federal government. Because of this, the law has been criticized by some as an unfunded mandate. Similarly, it has attracted controversy for its impacts on hospitals, and in particular, for its possible contributions to an emergency medical system that is "overburdened, underfunded and highly fragmented." Charity Care or care provided to the uninsured represent an industry average of 20% of total cost of care provided. The uncompensated or non-reimbursed amounts are written off as bad debt thus becoming a tax write off and the unpaid bills are also sold to third party collection agencies for an average of 20 cents per dollar. However, health insurance reimbursements for services provided have continually been reduced by the health insurance companies. Medicare and Medicaid reimbursements for services have also been reduced. However, EMTALA is independent of the payers, EMTALA is not similar to bad debt or charity care that MANY not-for-profit hospitals enjoy. However, the number of emergency room clinics, or emergency rooms not attached to a traditional hospital, have increased, as they are generally more efficient and cost less to operate than a traditional hospital-based emergency room. There is debate about the extent to which EMTALA has led to cost-shifting and higher rates for insured or paying hospital patients, thereby contributing to the high overall rate of medical inflation in the U.S.
Read more about Emergency Medical Treatment And Active Labor Act: Mandated and Non-mandated Care, Hospital Obligations
Famous quotes containing the words emergency, medical, treatment, active, labor and/or act:
“War-making is one of the few activities that people are not supposed to view “realistically”; that is, with an eye to expense and practical outcome. In all-out war, expenditure is all-out, unprudent—war being defined as an emergency in which no sacrifice is excessive.”
—Susan Sontag (b. 1933)
“Often, we expect too much [from a nanny]. We want someone like ourselves—bright, witty, responsible, loving, imaginative, patient, well-mannered, and cheerful. Also, we want her to be smart, but not so smart that she’s going to get bored in two months and leave us to go to medical school.”
—Louise Lague (20th century)
“Judge Ginsburg’s selection should be a model—chosen on merit and not ideology, despite some naysaying, with little advance publicity. Her treatment could begin to overturn a terrible precedent: that is, that the most terrifying sentence among the accomplished in America has become, “Honey—the White House is on the phone.””
—Anna Quindlen (b. 1952)
“All is changed. All looks strange to me and gives me a feeling which I would rather get away from, although I know it to be the carrying out of natural laws. And I am not complaining. I am doing the same as many old people have done, I suppose, who have led an active life and suddenly find themselves living without a purpose. Oh, my heart is so full. I could write a big book on the subject of going out of this world gracefully.”
—Maria D. Brown (1827–1927)
“In 1845 he built himself a small framed house on the shores of Walden Pond, and lived there two years alone, a life of labor and study. This action was quite native and fit for him. No one who knew him would tax him with affectation. He was more unlike his neighbors in his thought than in his action. As soon as he had exhausted himself that advantages of his solitude, he abandoned it.”
—Ralph Waldo Emerson (1803–1882)
“We call the intention good which is right in itself, but the action is good, not because it contains within it some good, but because it issues from a good intention. The same act may be done by the same man at different times. According to the diversity of his intention, however, this act may be at one time good, at another bad.”
—Peter Abelard (1079–1142)