Laws and Regulations | EMTALA limits

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Laws and Regulations

This area deals with identifying and interpreting the impact of government regulations and law on the organization; identifying the need for and working with others to develop new regulations and laws; investigating, monitoring, documenting, and enforcing existing statutes; and maintaining communication and cooperation with both public and private organizations.

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EMTALA limits

Posted by: Andrew Hillig on June 22, 2009 at 10:55PM EST

I'm wondering how other organizations are interpreting EMTALA. Most organizations have taken a very conservative stance on EMTALA given the negative publicility that can come from even being accused of patient dumping. Yet, over-use of the ED, increased wait times, increased bad debt ,and uncompensated care is forcing organizations to take a different approach with applying EMTALA.

Examples include:

1. Placing a physician/PA in the triage room to deliver the MSE, and securing payment once an emergency medical condition is determined to not be present.

2. With-hold discharge instructions/prescriptions until payment has been received

3. Triage-less ED's

4. Pre-scheduled ED appointments for non-emergency conditions.

5. Patient registration kiosks - which brings up a follow-up question as to how EMTALA applies to a patient when they self-register

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(3) Comments

Posted by: Gretchen Miller on June 23, 2009 8:33PM EST

EMTALA is something Ive never compltely inderstood myself. WE have sparse educatin at our hospital each year on a yearly computer based training but that is my very limited knowledge of it! I've never heard of with holding DC instrcuctions/prescriptions until payment has been received. Is that even legal I wouldn't think so. We don't have pre-scheduled appointments for non-emergency condtions but we have what is called fast track for minor issues during certain hours. I've also never heard of self- registration kiosks in ED's. It would as well seem like a liability for a hospital ED but maybe I just don't know enough about emergency medicine

Posted by: Douglas Romer on June 26, 2009 4:50PM EST

We take all patients and are very strict about providing the MSE prior to registration to avoid any issues with EMTALA. We do not require payment at the time of service for ER Patients.

Posted by: Paula Hafeman on October 22, 2009 8:23PM EST

To comply with EMTALA, we do a quick registration without asking insurance questions, and after the patient is seen by physician, test ordered, care provided then the registration is complete. We do the quick registration so we can order tests, meds etc.