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:
“In this country, you never pull the emergency brake, even when there is an emergency. It is imperative that the trains run on schedule.”
—Friedrich Dürrenmatt (1921–1990)
“As we speak of poetical beauty, so ought we to speak of mathematical beauty and medical beauty. But we do not do so; and that reason is that we know well what is the object of mathematics, and that it consists in proofs, and what is the object of medicine, and that it consists in healing. But we do not know in what grace consists, which is the object of poetry.”
—Blaise Pascal (1623–1662)
“Our treatment of both older people and children reflects the value we place on independence and autonomy. We do our best to make our children independent from birth. We leave them all alone in rooms with the lights out and tell them, “Go to sleep by yourselves.” And the old people we respect most are the ones who will fight for their independence, who would sooner starve to death than ask for help.”
—Margaret Mead (1901–1978)
“Women have acquired equal place to man in society, but the double standard has really never been relinquished; certainly not by men. Modern man’s fear of passivity or of the active woman proves to be as eternal as modern woman’s struggle to come to terms with her femininity.”
—Peter Blos (20th century)
“Writing poetry is the hard manual labor of the imagination.”
—Ishmael Reed (b. 1938)
“The ambivalence of writing is such that it can be considered both an act and an interpretive process that follows after an act with which it cannot coincide. As such, it both affirms and denies its own nature.”
—Paul De Man (1919–1983)