Every hospital with an emergency department that accepts Medicare and Medicaid payments must follow federal law and the Centers for Medicare and Medicaid Services Conditions of Participation Interpretive Guidelines on the Emergency Medical Treatment and Labor Act.

Hospitals without EDs must comply with EMTALA if they have specialized capabilities. For example, EMTALA can impact obstetrical patients and behavioral health patients. CMS made changes to include the Born-Alive Infant Protection Act with an updated survey memo.

This two-part series will cover the regulations and interpretive guidelines regarding EMTALA and all 12 sections and tag numbers. It also will offer an additional section for on-call physicians and the shared and community care plan process.

The series also will include a discussion on two EMTALA cases. The first — Moses v. Providence Hospital and Medical Centers, Inc., No. 07-2111 (6th Cir. April 2009) — created an enormous expansion of hospital and practitioner liability under federal law. The case overruled the CMS regulation that EMTALA obligations end when the hospital admits the patient in good faith. This illustrates the importance of understanding case law, which has a role in the outcome of EMTALA litigation. The second is a recent case against a hospital, the largest EMTALA settlement of $1.2 million. Health care is anticipated to see more considerable EMTALA fines and more activity because of the higher fines and the Office of Inspector General's final changes. These changes are not in the CMS CoPs and will be reviewed in this series.

Objectives:

Upon completion of this program, participants will be able to:

• recognize EMTALA as a frequently cited deficiency for hospitals
• recall that CMS has a manual on EMTALA that all hospitals that accept Medicare must follow
• recite the requirement that hospitals must maintain a central log
• discuss the hospital's requirement to maintain a list of the specific names of physicians who are on call to evaluate ED patients
• describe the CMS requirements on what must be in the EMTALA sign
• recall the hospital's requirements regarding a minor who is brought to the ED by a nonparent for a medical screening exam
• discuss when the hospital must complete a certification of false labor

Who Should Attend:

• Chief Medical Officers
• Chief Nursing Officers
• Compliance Officers
• Emergency Department Personnel
• TJC Coordinators, Medical Records Staff
• Quality Improvement Personnel
• Risk Managers and Legal Counsel