In a notice published on Feb. 2, 2012, in the Federal Register, the Centers for Medicare & Medicaid Services (CMS) solicited public comment on the applicability of the Emergency Medical Treatment and Active Labor Act (EMTALA) to inpatients and hospitals with specialized capabilities.
Also known as the patient anti-dumping statute, EMTALA generally requires that individuals with potential emergency medical conditions be provided an appropriate screening and stabilizing treatment or transfer, regardless of insurance or ability to pay. Under current law, an admitting hospital's obligations under EMTALA end when the hospital either stabilizes the patient in the ED, admits the patient or completes an appropriate transfer.
When an initial hospital lacks the capacity or capability to stabilize or admit the patient, another hospital with specialized services, such as an NICU or a burn unit, is obligated to accept the transfer if the patient needs such specialized capabilities. Under existing regulations and interpretive guidance, however, a hospital with specialized capabilities does not have an EMTALA obligation to accept a transfer from another hospital if the first hospital admitted the patient as an inpatient.
Although CMS is not specifically proposing a change to this policy, it is providing a 60-day period to allow the public to comment on the issue. (Comments must be received no later than 5 p.m. EST on April 2, 2012.) CMS is particularly interested in real-world examples and data, such as instances — or lack thereof — of hospitals with specialized capabilities refusing to accept transfers of patients requiring their specialized services.
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