EMTALA
Emergency Medical Treatment and Labor Act
Self-Learning Packet
INSTRUCTIONS:
1. Read the Packet
2. Complete post test and sign statement at bottom and return to Medical Staff Office
EMTALA stands for Emergency Medical Treatment and Labor Act. The law was passed by Congress as part of
the COBRA (Consolidated Omnibus Reconciliation Act) of 1985, informally known as the “anti-dumping
Law.”
EMTALA is applicable to any physician who is responsible for the examination, treatment
or transfer of an individual covered by EMTALA, including a physician on-call for the
care of such an individual. It is critical that all members of the medical staff understand
the EMTALA federal regulations, from both the perspective of transfer and acceptance of
patients.
The ramifications of non-compliance with EMTALA are sobering for both the institution and for the
practitioner and range from civil to criminal. Civil penalties include fines from $50,000 for practitioners and
for hospitals per violation as well as loss of Medicare and Medicaid federal payments.
EMTALA requires three duties of the Hospital. They are to…
1. Medical Screening Exam (MSE) – A MSE must be done on anyone who “comes to the Hospital” or
presents himself or herself on hospital property that has a dedicated emergency room seeking emergency
medical care. The purpose of the exam is to determine if an emergency medical condition exists and
transfer is needed by a qualified medical practitioner. This exam is performed by a physician and is
done, without delay, regardless of the person’s ability to pay.
An emergency medical condition exists when a person arrives on hospital property or “campus” with
severe symptoms and if immediate medical attention were not given it would result in:



Serious health risk to person or their unborn child (includes psychiatric disturbances and/or
symptoms of substance abuse)
Serious impairment to bodily function, or
Serious dysfunction of any body part or organ, OR
In the care of a pregnant woman who is having contractions:
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

In adequate time to effect a safe transfer to another hospital before delivery; OR
The transfer may threaten the safety of the woman or unborn child.
A pregnant woman, experiencing contractions, is in true labor unless a physician, certified nurse midwife, or
other qualified medical person acting within their scope of practice, certifies that after a reasonable time of
observation the woman is in false labor. Therefore, any woman considered to be in active labor is unstable
under EMTALA, preventing discharge or transfer unless the transferring hospital has absolutely no capability to
deliver the baby safely.
2. Stabilizing treatment must be provided to stabilize the medical condition within the capabilities of the
Hospital’s staff and facilities. If unable to stabilize an individual, the hospital must explain to the patient
the risks and benefits of the transfer and obtain the patient’s consent.
3. Appropriate Transfer or admission
The acceptable reasons for transfer would include:
1. The patient requires specialized care, not available at your hospital.
2. The patient or family requests the transfer (in this case the patient/family must also sign the InterInstitutional Transfer Form). The Hospital is not released from its EMTALA duty when a
patient/family requests transfer. All the conditions of transfer must be met.
Transfer is prohibited until the patient’s condition is stabilized, unless the conditions for transferring an
“unstable” patient, as set forth below, are met.
CMS defines “stable” as “No material deterioration is likely within reasonable medical probability, to result
from or occur during the transfer of the individual from a facility or that the pregnant woman with contractions
has delivered (including delivery of the placenta.)”
A patient may be transferred when “unstable” only when:
 The patient requests transfer after being informed of the risks and benefits
 The physician certifies on the Inter-Institutional Transfer Form that the medical benefits
outweigh the risks of transfer.
For further information, please refer to the hospitals’ EMTALA POLICY
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EMTALA POST TEST
1.
True
False
Uninsured fines of up to $50,000 per violation may be imposed on hospitals
and physicians for EMTALA violation.
2.
True
False
The EMTALA law applies to any person who comes to the hospital campus
or Emergency Department seeking medical care.
3.
True
False
The Hospital may lose its Medicare certification for violation of the
EMTALA law.
4.
True
False
EMTALA protects persons against discrimination based on ability to
to pay/insurance status, race, religion, sex, age or diagnosis.
5.
True
False
If a person comes to the Hospital for care and says that he does not have
any insurance, we do not have to treat him.
6.
True
False
EMTALA is known as the COBRA or the Anti-Dumping Law.
7.
True
False
If a person comes to the hospital lobby and states that he/she needs
emergency medical care you would escort the person to the
Emergency Department.
8.
True
False
Women in labor are exempt from EMTALA.
9.
True
False
Benefits and risks of a transfer must be explained to the patient
and documented on the Inter-Institutional Transfer Form.
10.
True
False
The EMTALA Law requires a MSE, stabilizing treatment and
appropriate transfer if necessary.
I have read, understand, and have had the opportunity to have my questions answered relative to EMTALA.
Signature:______________________________
Date:
Printed Name:
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