THE LAW IN ITS OWN (AND HCFA'S AND THE COURT'S) WORDS
Although the initial intent of EMTALA was to ensure nondiscriminatory access to emergency medical care, its practical ramifications have broadened significantly over the years and arise from 3 sources: the statute's original language (5); the interpretive guidelines that have been issued by HCFA, which are not merely suggestions but have the force of law; and the various federal court decisions that have resulted from alleged EMTALA violations. Because EMTALA is a federal statute, such cases are usually heard in federal courts. These include the federal district courts, the US Court of Appeals, and finally (in only one EMTALA-related case to date) the US Supreme Court.
EMTALA imposes 3 distinct legal duties on hospitals. According to the statute, only facilities that participate in Medicare are included, but this encompasses almost 98% of all US hospitals. First, hospitals must perform a medical screening examination (MSE) on any person who comes to the hospital and requests care to determine whether an emergency medical condition (EMC) exists. Second, if an EMC exists, hospital staff must either stabilize that condition to the extent of their ability or transfer the patient to another hospital with the appropriate capabilities. Finally, hospitals with specialized capabilities or facilities (e.g., burn units) are required to accept transfers of patients in need of such specialized services if they have the capacity to treat them.
THE LAW IN ITS OWN (AND HCFA'S AND THE COURT'S) WORDSAlthough the initial intent of EMTALA was to ensure nondiscriminatory access to emergency medical care, its practical ramifications have broadened significantly over the years and arise from 3 sources: the statute's original language (5); the interpretive guidelines that have been issued by HCFA, which are not merely suggestions but have the force of law; and the various federal court decisions that have resulted from alleged EMTALA violations. Because EMTALA is a federal statute, such cases are usually heard in federal courts. These include the federal district courts, the US Court of Appeals, and finally (in only one EMTALA-related case to date) the US Supreme Court.EMTALA imposes 3 distinct legal duties on hospitals. According to the statute, only facilities that participate in Medicare are included, but this encompasses almost 98% of all US hospitals. First, hospitals must perform a medical screening examination (MSE) on any person who comes to the hospital and requests care to determine whether an emergency medical condition (EMC) exists. Second, if an EMC exists, hospital staff must either stabilize that condition to the extent of their ability or transfer the patient to another hospital with the appropriate capabilities. Finally, hospitals with specialized capabilities or facilities (e.g., burn units) are required to accept transfers of patients in need of such specialized services if they have the capacity to treat them.
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