What is an EMTALA Violation?

Posted in: Medical Malpractice | Oct 18,2022

The Emergency Medical Treatment and Active Labor Act or EMTALA is a federal act that requires emergency departments to treat any person seeking emergency treatment regardless of their insurance status or ability to pay. If your emergency visit also resulted in medical malpractice, you may recover damages from both the EMTALA violation and medical malpractice. That is because hospitals and healthcare facilities are subject to civil liability for EMTALA violations. This post answers some frequently asked questions surrounding EMTALA.

What is EMTALA?

Even though most people might not be familiar with improper emergency treatment, the idea is nothing new. In 1986, U.S. legislators set the tone for what constituted improper care in a landmark law known as the Emergency Medical Treatment and Active Labor Act, or EMTALA, which covers any facility participating in Medicare.

The point of EMTALA was to level the playing field for those who needed it most–emergency patients. Until then, many hospitals engaged in patient dumping, which meant they would transfer patients to other facilities to make more money. For instance, if someone lacked insurance or didn’t “look like” they’d be able to foot their E.R. bill, a hospital might ship them down the road to another clinic.

Hospital dumping is a discriminatory practice going against the universal caregiver’s mission of “doing no harm.” When the law passed, most victims of this practice were members of minority groups, the unemployed, and other underserved populations. 

What are EMTALA’s 3 obligations?

Under EMTALA, hospitals must live up to three responsibilities:

  1. Hospitals must accept requests for incoming transfers if they have the capability and capacity (think open beds in trauma wards, diagnostic imaging machines, or specialized on-call doctors) to administer the unique care patients need.
  2. Hospitals must perform medical screening examinations (MSEs) on anyone who requests care in person and determine whether they need emergency help without delaying to confirm whether that individual has insurance or the ability to pay out of pocket.
  3. Hospitals have to stabilize emergency conditions to the best of their ability or transfer the patient to a facility that can do so. 

Which government agency is responsible for EMTALA?

The Centers for Medicare and Medicaid Services (CMS) is responsible for enforcing EMTALA. This may include everything from inspecting a hospital’s record of patient care for signs of violations to fining physicians and facilities that ignore the rules. If you want to report a violation, your local CMS liaison will be your point of contact for filing a complaint, although you may wish to consult an attorney first.

EMTALA and Medical Errors

Medical errors can occur in any treatment circumstance, but they’re often more dire in the case of emergencies. The healthcare profession typically divides medical errors into two categories:

  • Errors of commission happen when a caregiver takes the wrong action, like giving someone the incorrect surgery, performing the right surgery on the wrong limb, or prescribing the wrong dose of medication.
  • Errors of omission happen when a hospital or clinician fails to take specific actions, such as neglecting to set a broken bone or monitor a patient after surgery.

Regulators take a broad approach to defining what constitutes an emergency room medical error. For instance, some hospitals have received citations due to overly long on-call physician response times. They committed errors of omission because the specialist didn’t show up promptly enough to provide care. 

Other treatment errors may be less subtle or even cross into medical malpractice. For instance, a hospital might not consult your medical history before diagnosing you, or the doctor could fail to tell the nurses about your medication allergies. The key point to remember with these and other improper treatment synonyms is that they can all result in worse outcomes such as contracting a chronic condition requiring more corrective care that increases your bill or that results in death.

The Emergency Medical Treatment and Active Labor Act and Abortion 

In the summer of 2022, the U.S. Department of Health and Human Services (HHS) clarified that EMTALA applies to women who need emergency abortion services. This was an important step following the U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which rolled back federal abortion rights and potentially allowed states to punish doctors for providing such care. 

This guidance update from CMS overruled state law in numerous situations, including complications of pregnancy losses, severe preeclampsia, other hypertensive disorders, and ectopic pregnancies. Even if the local rules prohibit abortions without exceptions, the hospital must still administer EMTALA-mandated emergency treatment.

What should you do if you think your rights have been violated and you are injured?

Being injured is tough enough. Unfortunately, the legal challenges that may come with it only make it harder to find a path forward. At Montross Miller, we are experts in medical malpractice. We’re proud to help every one of our clients relieve the legal burdens of life-changing injuries in pursuit of a new start. Contact us for a free consultation to determine if you have been subject to improper emergency treatment.