The Emergency Medical Treatment and Active Labor Act (EMTALA) is a major compliance issue for hospitals and an area of increased government scrutiny. With the scope of EMTALA expanding, interpretive guidance from the Centers for Medicare and Medicaid Services (CMS) accumulating, and court decisions remaining inconsistent in their interpretations of the statute, medical directors, physicians and hospital administrators are understandably confused as to their specific obligations under EMTALA. Since even technical violations of EMTALA may subject a hospital to an action for termination of its Medicare participation agreement, such confusion can have devastating consequences. Experienced counsel in this area of law is an essential resource for our clients for whom we have:
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Developed hospital policies and procedures regarding EMTALA compliance;
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Modified hospital medical staff bylaws to ensure EMTALA compliance, including medical staff bylaws for a national, for-profit hospital corporation;
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Advised hospital clients on day-to-day issues regarding EMTALA, including missed call coverage, the definition of transfer, on call response times, scope of available emergency services, specialized capability, documentation requirements, designation of QMPs, self-reporting obligations and the interaction between EMTALA and other laws and regulations affecting hospitals;
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Developed plans of correction for hospitals notified by CMS that they are out of compliance and assisting in implementation of such plans;
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Successfully negotiated with the Office of Inspector General (OIG) to forestall a 23-day notice of termination of Medicare participation because of an alleged EMTALA violation;
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Analyzed on behalf of a hospital whether a competitor was engaged in inappropriate transfers under EMTALA;
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Analyzed when a patient comes to the emergency department under EMTALA based on the new provider-based regulations;
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Assisted hospitals in developing protocols for off-campus hospital-based departments, including designating QMPs and providing appropriate notices to patients;
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Assisted hospitals in conducting and designing staff training programs for EMTALA compliance, both generally and with respect to implementing a plan of correction; and
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Successfully defended a hospital in a PRO hearing involving an alleged EMTALA violation.