EMTALA
The law has ensured that all patients can receive the emergency care they need, which has transformed the ED into society's de facto safety net - Eric Maughan MD

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EMTALA: Things You Never Knew (or Never Thought to Ask)
EMTALA transformed the ED from a place strictly for emergencies into America's safety net. The requirement to treat everyone before getting payment (and often never getting payment) has not only contributed to ED overcrowding, but also imposed a huge burden of uncompensated care upon hospitals – to the tune of billions of dollars each year. There is no provision in EMTALA to address this unintended consequence, in effect making it the largest unfunded mandate ever imposed on the health care sector. However, EMTALA also established health care as a right for all people, not a privilege afforded only to the rich. It has additionally saved countless lives by preventing the transfer or rejection…
Resources
All About EMTALA: The Law That Runs the ED
Emergency physicians treat any patient with any emergent condition regardless of other factors, as EMTALA mandates. Stabilizing and transferring patients appropriately are aspects of the law, and should also be aspects of good patient care. But while EMTALA has helped our patients and society, it has also put a significant financial burden on hospitals. We need to keep pushing against policies that increase uncompensated care, so that we can continue to care for any one, with anything, and any time.
EMTALA and abortions: An explainer and research roundup
Legal experts worry that if the Supreme Court rules in favor of Idaho and allows states to shape their own laws for pregnancy emergencies without regard to EMTALA, then the states could apply the same logic to all other forms of emergency medical care that currently covered under the federal emergency law.
I’m an ER Doctor. If the Supreme Court Upends EMTALA, Patients Will Die
Thanks to EMTALA, emergency room doctors are trained to treat life-threatening pregnancy-related emergencies. That treatment needs to include an abortion.
What to Know About the Federal Law at the Heart of the Latest Supreme Court Abortion Case
One of the newest battlefields in the abortion debate is a decades-old federal law called the Emergency Medical Treatment and Labor Act, known by doctors and health policymakers as EMTALA. The issue involves whether the law requires hospital emergency rooms to provide abortions in urgent circumstances, including when a woman’s health is threatened by continuing her pregnancy. But, as with many abortion-related arguments, this one could have broader implications. Some legal experts say it could potentially determine how restrictive state abortion laws are allowed to be and whether states can prevent emergency rooms from providing other types of medical care, such as gender-affirming treatments.
Will the Supreme Court Let Doctors Do No Harm?
For nearly 40 years, the Emergency Medical Treatment and Labor Act (EMTALA) has protected my patients' access to emergency medical care. The law guarantees that patients in critical condition, including those in active labor, cannot be turned away from emergency departments. However, the Supreme Court will soon hear a case brought by the state of Idaho—and will determine whether or not hospitals across the country are allowed to provide abortion care to women experiencing emergencies.
EMTALA: The Law That Forever Changed the Practice of EM
Yes, EMTALA contributed to crowding, boarding, lack of specialty coverage, increased transfers, and governmental insertion into the practice of medicine, and it poses a giant unfunded mandate on emergency providers. However, it unquestionably saves lives. It affirms the unique and venerable role of the specialty of emergency medicine as the safety net of the U.S. health care system. ACEP should be proud of its 50 years advocating for patient access to emergency care, and EMTALA has profoundly facilitated that mission.
The EMTALA Paradox
The federal government's expansion and enforcement of the Emergency Medical Treatment and Labor Act (EMTALA) is actually diminishing the very access it was intended to promote, according to a new article in the November issue of Annals of Emergency Medicine.
When Does EMTALA Apply? The Semantics of Emergency Care
A recent court case challenges whether “urgent” care clinics will have to meet the same EMTALA standards as a dedicated emergency department.
Why do we need EMTALA (the Emergency Medical Treatment and Labor Act)?
Emergency pregnancy care under EMTALA — the Emergency Medical Treatment and Labor Act — is at risk. This federal law was passed nearly 40 years ago to ensure everyone can access emergency medical care. The law requires hospitals to screen all patients and treat anyone experiencing an emergency medical condition with stabilizing care. The courts, Congress, physicians, and hospitals have recognized the law for decades. EMTALA supersedes state law, as its language makes clear. But states with total abortion bans, like Idaho, want to change that. They argue that their abortion bans mean they can ignore EMTALA, and “ban” pregnant people’s access to care in emergency care situations.
EMTALA and Physician Assistants
The EMTALA law and regulations allow physician assistants (PAs) to conduct MSEs. A hospital’s written policies must specify that PAs are among the providers qualified to conduct them. Individual PAs must have privileges to perform the exams.
EMTALA Requirements: What You Need to Know
The Emergency Medical Treatment & Labor Act (EMTALA), often referred to as the “anti-dumping” law, was enacted by Congress in 1986 to ensure access to emergency services, regardless of an individual’s ability to pay. EMTALA requirements apply to every Medicare-participating hospital that offers emergency services.
EMTALA – Understand the Basics of the Emergency Medical Treatment and Active Labor Act
Spend any time in the emergency room and you have crossed paths with the Emergency Medical Treatment and Active Labor Act (EMTALA) and the complexities of the law. What was the impetus that drove the law into existence? President Ronald Reagan signed the anti-dumping law (EMTALA) passed by congress over 35 years ago in response to an epidemic of small local hospitals failing to screen, treat and then transfer unstable emergency patients and women in labor—to nearby public hospitals and academic medical centers, often for financial reasons. In short, EMTALA ensures the public access to emergency services regardless of their financial status.
EMTALA: What EMS providers should know
I’ve heard many EMS professionals say that EMTALA does not apply to ambulance services, and technically this is a true statement. However, this letter provides the prime example of why we should be familiar with the EMTALA regulations; because even if EMTALA does not apply to us, it effects our patients.
Is EMTALA That Bad?
After an overview of EMTALA’s history and basic requirements, this article examines the act from two opposing perspectives. One perspective looks at EMTALA as an unfunded congressional mandate for universal access to all that shifts the cost of this access to the hospitals. The other views EMTALA as one more victim of a broken health care delivery system and a scapegoat for the nation’s health care woes.
Is “Severe Pain” considered an emergency medical condition under EMTALA?
There exists a common misconception that both the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission consider “severe pain” to be an emergency medical condition under the Emergency Medical Treatment and Labor Act (EMTALA), and that the law mandates the emergency physician to prescribe medication to treat a patient’s pain. The short answer to the title question is, “No.” Severe pain is NOT in and of itself an emergency medical condition under EMTALA. The long answer is, as your clinical instinct would suggest, “It depends.”
The Anatomy of EMTALA: A Litigator's Guide
The Emergency Medical Treatment and Active Labor Act (EMTALA) prohibits hospitals from inappropriately transferring or refusing medical care to persons with emergency medical conditions. EMTALA was passed in response to the practice of “dumping” seriously ill patients from private hospitals into public ones, to ensure all patients receive medical treatment in emergency situations.
The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physicians
The Emergency Medical Treatment and Active Labor Act (EMTALA) was passed by the US Congress in 1986 as part of the Consolidated Omnibus Reconciliation Act (COBRA), much of which dealt with Medicare issues. The law's initial intent was to ensure patient access to emergency medical care and to prevent the practice of patient dumping, in which uninsured patients were transferred, solely for financial reasons, from private to public hospitals without consideration of their medical condition or stability for the transfer.
The Impact Of EMTALA
Although EMTALA was intended to support the rights of the indigent patient, there have been unanticipated consequences of the law. These consequences include heavy monetary implications for those hospitals that constitute the safety net for this patient population and provide a disproportionate volume of uncompensated care
Understanding EMTALA
How does EMTALA define an emergency? An emergency medical condition is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs."
What On-Call Physicians Need to Know about EMTALA
EMTALA ensures that patients receive stabilizing treatment when presenting to an emergency department or are appropriately transferred to a capable facility. The act includes strict rules that apply to a hospital’s on-call physicians—those who provide the stabilizing treatment. It’s important that physicians understand those requirements and the potential risks and penalties non-compliance can impose.
EMTALA: Things You Never Knew (or Never Thought to Ask)
We all know the basic tenets of this legislation: provide medical screening exams, stabilize emergency medical conditions, transfer to a higher level of care as appropriate — and do all this without regard to ability to pay. But what about the finer points of this complex law?
Emergency Medical Treatment & Labor Act (EMTALA)
In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.
Overview of the Emergency Medical Treatment and Active Labor Act (EMTALA) and Emergency Abortion Services
The Emergency Medical Treatment and Active Labor Act (EMTALA, largely codified in Section 1867 of the Social Security Act, 42 U.S.C. § 1395dd) is a federal law that generally compels Medicare-participating hospitals to provide emergency care to any individual, irrespective of an individual’s ability to pay. Enacted in 1986 amid reports of hospital emergency rooms refusing to treat poor or uninsured patients, the Act requires hospitals, as a condition of federal Medicare funding, to provide services to any individual presenting at an emergency department or face potential enforcement action.
Certification and Compliance For The Emergency Medical Treatment and Labor Act (EMTALA)
The provisions of EMTALA apply to all individuals (not just Medicare beneficiaries) who attempt to gain access to a hospital for emergency care. The regulations define “hospital with an emergency department” to mean a hospital with a dedicated emergency department.

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