Emergency Medical Treatment And Labor Act

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A U.S. law, the Emergency Medical Treatment and Active Labor Act (EMTALA) requires every emergency service (i.e., emergency medical services and emergency rooms) that receives federal funds (essentially all) to evaluate every patient presenting to them. If the patients are medically unstable, they must be stabilized before discharge, and, if transferred, the transfer must be done in a medically safe manner.

This Act requires the evaluation take place whether or not the patient is able to pay. It is not, as many people believe, a mandate for free emergency care. Other than that it is an unfunded mandate where the emergency provider has to cover the cost of individuals who cannot pay, it is a sensible law. Think of the contingency of Bill Gates being found unconscious in a car accident, not being recognized, and not being treated because he could not provide an insurance card from his damaged clothing. Providers can still take vigorous collection activities against emergency patients.

From the service's risk management standpoint, it is essential to able to track the timeline from first emergency service contact to disposition, and that disposition has followed the rules. Failing to follow EMTALA can cause cutoff of all Federal reimbursement (Medicare, research) and open the provider to suit.

EMTALA is largely an unfunded mandate, controversial because it tends to make emergency rooms, the most expensive way to deliver services, the primary treatment facility for the uninsured and for illegal immigrants. The Medicare Prescription Drug, Improvement and Modernization Act of 2003, which contained Sec. 1011 authorizing $250,000 annually between 2003 and 2008 for government reimbursements to hospitals who provide treatment for uninsured illegal immigrants.^[1] The measure attempted to partially defray hospital costs incurred over the continuing unfunded mandate of EMTALA emergency care law.

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