Must Emergency Rooms treat uninsured destitute patients?
If so, how long?
Emergency Medical Treatment & Labor Act (EMTALA)
Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented. Wikipedia * CMS.gov
In 1986, Congress enacted the to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide:
a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual’s ability to pay.
emergency department as “a specially equipped and staffed area of the hospital used a significant portion of the time for initial evaluation and treatment of outpatients for emergency medical conditions .” This means, for example, that outpatient clinics not equipped to handle medical emergencies are not obligated under EMTALA and can simply refer patients to a nearby emergency department for care.
An emergency medical condition (EMC) is defined as “a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual’s health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs.” For example, a pregnant woman with an emergency condition must be treated until delivery is complete unless a transfer under the statute is appropriate.
Patients treated under EMTALA may not be able to pay or have insurance –
get a complementary quote
or other programs like Medi-Cal pay for the associated costs but are legally responsible for any costs incurred as a result of their care under civil law.
- The patient is conscious, alert, and oriented.
- The cause of all symptoms reported by the patient or representative, and all potentially life-threatening, limb-threatening, or organ-threatening symptoms discovered by hospital staff, has been ascertained to the best of the hospital’s ability.
- Any conditions that are immediately life-threatening, limb-threatening, or organ-threatening have been treated to the best of the hospital’s ability to ensure the patient does not need further inpatient care.
- The patient is able to care for himself or herself, with or without special equipment, which if needed, must be provided. The required abilities are:
The “prudent layperson” definition of an emergency medical condition is any medical or behavioral condition of recent onset and severity, not limited to severe pain, that would lead a typical person possessing an average knowledge of medicine and health to believe that his or her condition, sickness, or injury is of such a nature that failure to obtain immediate medical care could jeopardize life, limb, or mental health. The presenting sign or symptom is paramount, not the final diagnosis, when determining whether to pay emergency medical claims. RAC Monitor Hospitals must screen patients who come to the ER *
Problems with this definition and how expenses health care inflation have increased CMS.gov 100 – 07 Emergency Cases * acepnow.com/prudent-layperson-standard-emergency-medicine-attack/ *
Links & Resources
Attorney Website Injury Claim Coach
What is Patient Abandonment?
When a doctor doesn’t end the provider-patient relationship properly, it could amount to malpractice
Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.
If a doctor intentionally refuses to treat a patient who has failed to pay his or her medical bill, that is often considered unjustified. And if a doctor is unavailable for an unreasonable amount of time when a patient needs medical care — and so is the backup (or “on call”) doctor — that could amount to patient abandonment if the patient ends up suffering harm as a result.
So, this may very well be a reason, to ask for Insurance FIRST, before accepting one as a patient! Get instant health insurance quotes here.
Covered CA Certified Agent
No extra charge for complementary assistance
- Appoint us as your broker
- VIDEO on ARPA Stimulus and more Covered CA Subsidies
- Set Consultation Meeting via Phone, Skype or Zoom
- Instant Health Quotes, Subsidy Calculation & Enroll
Videos on how great agents are
Enrolling in health plans has helped people focus on their families and careers, and feel protected against unexpected medical issues.