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Federal Focus on EMTALA: HHS Goes on the Offensive

January 31, 2024

On Jan 22, 2024, the Department of Health and Human Services (HHS) put out a press release, announcing that it will launch new initiatives in support of the Emergency Medical Treatment and Labor Act (EMTALA). The law, passed back in 1986, requires hospitals with emergency departments to adhere to a certain set of standards, to include the following:

  • Provide all patients with a medical screening examination (MSE)
  • Stabilize any patients with an emergency medical condition
  • Transfer or accept appropriate patients as needed
  • Screen and treat the emergency medical conditions of patients in a non-discriminatory manner to anyone, regardless of their ability to pay, insurance status, national origin, race, creed or color
  • Treat the patient’s condition to stabilize it or to make a transfer to an appropriate facility if an emergency medical condition exists

Again, the law is intended to address patient emergencies and the hospital’s responsibilities when such emergent conditions exist.

The New Push

This law has been on the books for some time, but the federal government is now concerned that its force and effect after 38 years may be waning and in need of some invigorative measures. To that end, HHS will begin an educational campaign, alerting the general public about their rights to emergency medical care. The department will simultaneously engage in efforts to aid hospitals in meeting of their obligations under the law. This two-pronged approach will include the following efforts:

  • Publish new informational resources on the Centers for Medicare and Medicaid Services (CMS) website to help individuals understand their rights under EMTALA
  • Inform the public via the CMS website concerning the process for submitting a complaint if they are denied emergency medical care
  • Partner with hospital and provider associations to disseminate training materials on providers’ obligations under EMTALA
  • Convene hospital and provider associations to discuss best practices and challenges in ensuring compliance with EMTALA
  • Establish a dedicated team of HHS experts who will increase the Department’s capacity to support hospitals in complying with federal requirements under EMTALA

All this sounds pretty routine and non-threatening, but this new push by the government does raise a few questions, such as: why the renewed emphasis and why now?

The Triggering Event

According to the previously referenced press release, this comprehensive action plan was developed by HHS “in response to a growing number of inquiries from patients and providers to CMS about how they can ensure that federal obligations were being met.” Significantly, there was a concern raised specifically about “patients who are experiencing pregnancy loss and other pregnancy-related emergencies” having access to emergency medical care, “as required under federal law.” Indeed, the press release concludes by stating the following:

The Biden-Harris Administration remains focused on working with doctors, hospitals, and patients to promote patient access to the care that they are entitled to under federal law and has long taken the position that this required emergency care can, in some circumstances, include abortion care. The U.S. Department of Justice is currently defending that understanding before the Supreme Court.

As it turns out, in early January, a federal appeals court ruled that federal regulations do not require emergency rooms to perform life-saving abortions if it would run afoul of state law. The court signaled agreement with a lower court ruling that “EMTALA does not provide an unqualified right for the pregnant mother to abort her child” and concluding that “EMTALA does not mandate medical treatments, let alone abortion care, nor does it preempt [state] law.”

So, whether these new federal efforts in support of EMTALA will set the stage for the latest battleground in the abortion debate remains to be seen. However, it would behoove hospital administrators to bone up on the specific provisions of EMTALA and consult with their healthcare attorneys where necessary. After all, the government is on its way with educational materials, expert guidance and its own brand of special encouragement. It may pay to be prepared.

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