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)
“There may perhaps be a new generation of doctors horrified by lacerations, infections, women who have douched with kitchen cleanser. What an irony it would be if fanatics continued to kill and yet it was the apathy and silence of the medical profession that most wounded the ability to provide what is, after all, a medical procedure.”
—Anna Quindlen (b. 1952)
“Ambivalence reaches the level of schizophrenia in our treatment of violence among the young. Parents do not encourage violence, but neither do they take up arms against the industries which encourage it. Parents hide their eyes from the books and comics, slasher films, videos and lyrics which form the texture of an adolescent culture. While all successful societies have inhibited instinct, ours encourages it. Or at least we profess ourselves powerless to interfere with it.”
—C. John Sommerville (20th century)
“So hills and valleys into singing break;
And though poor stones have neither speech nor tongue,
While active winds and streams both run and speak,
Yet stones are deep in admiration.
Thus praise and prayer here beneath the Sun
Make lesser mornings when the great are done.”
—Henry Vaughan (1622–1695)
“The habits of our whole species fall into three great classes—useful labour, useless labour, and idleness. Of these the first only is meritorious; and to it all the products of labor rightfully belong; but the two latter, while they exist, are heavy pensioners upon the first, robbing it of a large portion of its just rights. The only remedy for this is to, as far as possible, drive useless labour and idleness out of existence.”
—Abraham Lincoln (1809–1865)
“To exist is equivalent to an act of faith, a protest against the truth, an interminable prayer.... As soon as they consent to live, the unbeliever and the man of faith are fundamentally the same, since both have made the only decision that defines a being.”
—E.M. Cioran (b. 1911)