The Emergency Medical Treatment and Active Labor Act was passed while Reagan was in office back in 1986. The goal was to stop hospitals from refusing to care for people having serious medical emergencies because they didn’t have insurance or couldn’t pay for treatment. This was happening at an alarming rate even to people with gunshot wounds. People who were treated were often transferred to public hospitals before they were stabilized which is called “patient dumping”.
When does EMTALA apply? It applies when you go to an emergency department. An urgent care or doctor’s office is not equipped to handle emergencies so EMTALA wouldn’t apply. The gist of the law is that if you go in requesting an exam to determine if there is an emergency condition they have to give it to you and can’t delay by asking about your ability to pay. If an emergency condition exists they have to provide treatment until it is resolved or stabilized. Hospitals with specialized capabilities are required to accept transfers. If a receiving hospital believes someone was transferred into their care before being stabilized they must report it.
How do you report a violation of EMTALA and to who? That is the interesting part. I recently helped a client who was in a serious car wreck and went to a Jonesboro hospital. He had multiple broken limbs requiring surgery and for some reason it took about one week for him to get the surgery which required a transfer to central Arkansas. There were some hiccups with the transfer and the surgery was delayed again. The first thing I did was contact the regional office of The Centers for Medicaid and Medicare Services Office (CMS…yes one “M”) which for Arkansas is located in Texas. Nobody answered the phone. I left voicemails and nobody returned them. I emailed the addresses on the website and got a response fairly quickly but they referred me to a different department which I had to email multiple times. There is no actual process or online intake forms for an EMTALA complaint! Eventually someone emailed me back who could help. All I was asked to do was email what happened. I was shocked at the informality of the process and the lack of transparency. About 8 months later I received a letter stating that there was no violation. The rationale for the decision wasn’t included. The evidence or information used to reach that decision wasn’t included either. The letter I received said the following, “Consequently, we found no violation of 42 CFR 489.24 or 42 CFR 489.20 by the hospital. Based on your individual situation, however, you may wish to consider the civil enforcement provisions of 1867 of the Social Security Act on an independent basis.”
Hopefully this clarifies a process which is anything but clear! More importantly knowing that EMTALA exists, what the acronym stands for, and that it applies to a woman who is in labor is very important when advocating for yourself in a hospital setting. If a complaint is found to have merit the hospital can be fined. If you’ve had an EMTALA complaint that was successful please let me know about it!