According to the “Emergency Medical Treatment and Labor Act” (EMTALA), hospitals are now required to have their emergency department (ED) arrange for a medical screening examination to any patient who enters the ED and needs such an examination. The law forbids hospitals with emergency departments from declining to examine or treat individuals with an emergency medical condition.
The requirements of EMTALA apply to all patients (not just Medicare beneficiaries) who request to gain access to a hospital for emergency care. The guidelines define “hospital with an emergency department” to mean a hospital with a dedicated emergency department.
In turn, the regulation defines “dedicated emergency department” as any department or facility of the hospital that either –
- Is authorized by the state as an emergency department
- Is regarded in the public as providing treatment for emergency medical conditions; or
- One-third of the visits to the department in the previous calendar year actually provided treatment for emergency medical conditions on a critical basis.
Hospitals with dedicated emergency departments are required to take the following measures per EMTALA:
- Adopt and impose policies and procedures to conform with the requirements of 42 CFR §489.24;
- Post signs in the devoted ED determining the privileges of people with crisis restorative conditions and ladies in labor who go to the committed ED for human services benefits, and demonstrate on the signs whether the healing facility takes part in the Medicaid program;
- Maintain medical and different records identified with people exchanged to and from the hospital for a time of five years from the date of the exchange;
- Keep a list of physicians who are on-call to deliver further evaluation and or treatment necessary to stabilize an individual with an emergency medical condition;
- Keep a central record of individual’s who come to the dedicated ED seeking treatment and designate whether these individuals:
- Refused treatment,
- Were denied treatment,
- Were treated, admitted, stabilized, and/or transferred or were discharged;
- Provide for a proper medical screening examination;
- Provide essential balancing out treatment for crisis medicinal conditions and work inside the healing facility’s ability and limit;
For more on EMTALA join compliance expert Duane C. Abbey, in a Live Conference to get advice on EMTALA and issues associated with coding, billing and reimbursement for the ED particularly under the Medicare program.